| NPI | 1457580003 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RR0500X Internal Medicine, Rheumatology (Licence: KY 44608) |
| Additional Taxonomies | 207RA0401X Internal Medicine, Addiction Medicine (Licence: KY 44608) |
| Enumeration Date | 2009-07-03 |
| Last Update Date | 2018-03-17 |