| NPI | 1477084622 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083A0300X Preventive Medicine, Addiction Medicine (Licence: MA 287992) |
| Additional Taxonomies | 2083P0500X Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine (Licence: MA 287992) |
| 207R00000X Internal Medicine (Licence: MA 287992) | |
| Enumeration Date | 2017-03-21 |
| Last Update Date | 2026-06-18 |