| NPI | 1750339032 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RA0401X Internal Medicine, Addiction Medicine (Licence: FL ME87491) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: FL ME87491) |
| 207R00000X Internal Medicine (Licence: FL ME87491) | |
| Enumeration Date | 2006-05-05 |
| Last Update Date | 2020-07-27 |