| NPI | 1912926510 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MI 4301064922) |
| Additional Taxonomies | 207RG0300X Internal Medicine Geriatric Medicine (Licence: MI 4301064922) |
| 207RH0002X Internal Medicine Hospice and Palliative Medicine (Licence: MI 4301064922) | |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2014-06-24 |