| NPI | 1902484082 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0002X Internal Medicine, Hospice and Palliative Medicine (Licence: OH 34.018221) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA 20A22814) |
| Enumeration Date | 2021-03-31 |
| Last Update Date | 2025-09-24 |