| NPI | 1316063357 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RA0401X Internal Medicine Addiction Medicine (Licence: FL ME32575) |
| Additional Taxonomies | 2083P0500X Preventive Medicine Preventive Medicine/Occupational Environmental Medicine (Licence: FL ME32575) |
| 2083X0100X Preventive Medicine Occupational Medicine (Licence: FL 32575) | |
| Enumeration Date | 2007-03-21 |
| Last Update Date | 2023-01-19 |