| NPI | 1982043105 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RH0002X Internal Medicine, Hospice and Palliative Medicine (Licence: WI 6734621) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125063761) |
| 207R00000X Internal Medicine (Licence: WI 67346) | |
| Enumeration Date | 2013-06-20 |
| Last Update Date | 2021-11-23 |