| NPI | 1295803534 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MA 232230) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: MA 232230) |
| 207RA0401X Internal Medicine, Addiction Medicine (Licence: MA 232230) | |
| Enumeration Date | 2006-12-04 |
| Last Update Date | 2025-11-17 |