| NPI | 1427283530 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA A46392) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CA A46392) |
| 207RA0401X Internal Medicine, Addiction Medicine (Licence: CA A46392) | |
| Enumeration Date | 2009-05-18 |
| Last Update Date | 2009-05-18 |