| NPI | 1497902993 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RA0401X Internal Medicine, Addiction Medicine (Licence: CA C41863) |
| Additional Taxonomies | 174400000X Specialist (Licence: CA C 41863) |
| Enumeration Date | 2008-08-26 |
| Last Update Date | 2024-01-03 |