| NPI | 1891840237 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MO 101414) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MO 101414) |
| 207RH0002X Internal Medicine, Hospice and Palliative Medicine (Licence: MO 101414) | |
| Enumeration Date | 2007-01-24 |
| Last Update Date | 2025-07-23 |