| NPI | 1891749305 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: KY 38794) |
| Additional Taxonomies | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: KY 38794) |
| 207RH0002X Internal Medicine, Hospice and Palliative Medicine (Licence: KY 38794) | |
| Enumeration Date | 2006-05-20 |
| Last Update Date | 2024-09-10 |