| NPI | 1588684674 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 036066534) |
| Additional Taxonomies | 207RA0401X Internal Medicine, Addiction Medicine (Licence: IL 036.066534) |
| Enumeration Date | 2006-07-20 |
| Last Update Date | 2024-07-12 |