| NPI | 1598710170 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: VA 0101051566) |
| Additional Taxonomies | 204D00000X Neuromusculoskeletal Medicine & OMM (Licence: VA 0101051566) |
| 2083A0300X Preventive Medicine, Addiction Medicine (Licence: VA 0101051566) | |
| Enumeration Date | 2006-05-23 |
| Last Update Date | 2022-09-21 |