| NPI | 1295704393 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083A0300X Preventive Medicine, Addiction Medicine (Licence: TN MD28076) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TN MD28076) |
| 207RA0401X Internal Medicine, Addiction Medicine (Licence: TN MD28076) | |
| Enumeration Date | 2006-03-14 |
| Last Update Date | 2023-01-31 |