| NPI | 1902423767 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0002X Internal Medicine, Hospice and Palliative Medicine (Licence: MI 4301509379) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MI 4351046584) |
| Enumeration Date | 2020-06-28 |
| Last Update Date | 2023-06-14 |