| NPI | 1932650447 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: LA 324871) |
| Additional Taxonomies | 207QH0002X Family Medicine, Hospice and Palliative Medicine (Licence: AZ R77306) |
| 207R00000X Internal Medicine (Licence: FL 23900) | |
| Enumeration Date | 2016-10-19 |
| Last Update Date | 2020-11-06 |