| NPI | 1083093272 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RA0401X Internal Medicine, Addiction Medicine (Licence: IN 02004981A) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IN 02004981A) |
| Enumeration Date | 2015-05-21 |
| Last Update Date | 2022-10-10 |