| NPI | 1285809772 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RA0401X Internal Medicine, Addiction Medicine (Licence: CA A125825) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: CA A125825) |
| Enumeration Date | 2008-04-25 |
| Last Update Date | 2026-05-26 |