| NPI | 1033326970 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2083A0300X Preventive Medicine Addiction Medicine (Licence: MI 5304001212) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301084363) |
| Enumeration Date | 2007-05-17 |
| Last Update Date | 2021-03-16 |