| NPI | 1972505410 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL OS8550) |
| Additional Taxonomies | 207RH0002X Internal Medicine, Hospice and Palliative Medicine (Licence: FL OS8550) |
| 207RH0002X Internal Medicine, Hospice and Palliative Medicine (Licence: GA 056084) | |
| Enumeration Date | 2005-08-15 |
| Last Update Date | 2015-04-01 |