| NPI | 1134142987 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RA0401X Internal Medicine Addiction Medicine (Licence: TN 10243) |
| Additional Taxonomies | 207VG0400X Obstetrics & Gynecology Gynecology (Licence: TN 10243) |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2024-12-24 |