| NPI | 1528063252 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RA0401X Internal Medicine, Addiction Medicine (Licence: LA 13289R) |
| Additional Taxonomies | 207RH0002X Internal Medicine, Hospice and Palliative Medicine (Licence: LA 13289R) |
| 207R00000X Internal Medicine (Licence: LA 13289R) | |
| Enumeration Date | 2005-06-17 |
| Last Update Date | 2023-09-11 |