| NPI | 1619081726 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RA0401X Internal Medicine, Addiction Medicine (Licence: PA MD025875E) |
| Additional Taxonomies | 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine (Licence: PA MD025875E) |
| Enumeration Date | 2006-08-18 |
| Last Update Date | 2022-02-07 |