| NPI | 1245262617 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RA0401X Internal Medicine, Addiction Medicine (Licence: CA C179725) |
| Additional Taxonomies | 207RA0401X Internal Medicine, Addiction Medicine (Licence: IL 036111915) |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2022-08-12 |