| NPI | 1497827745 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2083A0300X Preventive Medicine, Addiction Medicine (Licence: CA 96644) |
| Additional Taxonomies | 207RA0401X Internal Medicine, Addiction Medicine (Licence: CA A96644) |
| 207W00000X Ophthalmology (Licence: CA A96644) | |
| Enumeration Date | 2006-11-14 |
| Last Update Date | 2022-03-03 |