| NPI | 1528504891 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2083A0300X Preventive Medicine, Addiction Medicine (Licence: HI MD20017) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: HI MD20017) |
| Enumeration Date | 2017-01-11 |
| Last Update Date | 2024-08-12 |