| NPI | 1497765572 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MD D0024602) |
| Additional Taxonomies | 207RA0401X Internal Medicine, Addiction Medicine (Licence: MD D0024602) |
| 2083X0100X Preventive Medicine, Occupational Medicine (Licence: MD D0024602) | |
| Enumeration Date | 2006-08-09 |
| Last Update Date | 2022-02-07 |