| NPI | 1750337325 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NC 9901172) |
| Additional Taxonomies | 2084A0401X Psychiatry & Neurology, Addiction Medicine (Licence: NC 9901172) |
| 207RA0401X Internal Medicine, Addiction Medicine (Licence: NC 9901172) | |
| 174400000X Specialist (Licence: NC 9901172) | |
| Enumeration Date | 2006-05-25 |
| Last Update Date | 2024-06-20 |