| NPI | 1023365939 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RH0002X Internal Medicine, Hospice and Palliative Medicine (Licence: CA A129294) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A129294) |
| 207RA0401X Internal Medicine, Addiction Medicine (Licence: CA A129294) | |
| Enumeration Date | 2012-08-09 |
| Last Update Date | 2019-12-19 |