| NPI | 1962580589 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CT 067712) |
| Additional Taxonomies | 207QH0002X Family Medicine, Hospice and Palliative Medicine (Licence: CT 067712) |
| 207QG0300X Family Medicine, Geriatric Medicine (Licence: CA g50400) | |
| 207QH0002X Family Medicine, Hospice and Palliative Medicine (Licence: CA g50400) | |
| 207R00000X Internal Medicine (Licence: CA g50400) | |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2024-10-31 |