| NPI | 1750799771 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2083A0300X Preventive Medicine, Addiction Medicine (Licence: CA A133295) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A133295) |
| Enumeration Date | 2014-07-23 |
| Last Update Date | 2025-06-18 |