| NPI | 1295741460 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 044536) |
| Additional Taxonomies | 207QA0401X Family Medicine Addiction Medicine (Licence: GA 044532) |
| 207R00000X Internal Medicine (Licence: GA 044532) | |
| 207RA0401X Internal Medicine Addiction Medicine (Licence: GA 044532) | |
| 207RH0002X Internal Medicine Hospice and Palliative Medicine (Licence: GA 044532) | |
| Enumeration Date | 2006-07-31 |
| Last Update Date | 2022-07-07 |