| NPI | 1962814640 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL OS15414) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL U04033) |
| 207RH0002X Internal Medicine, Hospice and Palliative Medicine (Licence: FL OS15414) | |
| Enumeration Date | 2014-05-29 |
| Last Update Date | 2022-03-10 |