| NPI | 1922049188 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA 20A369) |
| Additional Taxonomies | 2081H0002X Physical Medicine & Rehabilitation, Hospice and Palliative Medicine (Licence: CA 20A369) |
| Enumeration Date | 2006-06-09 |
| Last Update Date | 2025-06-17 |