| NPI | 1801208798 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RA0401X Internal Medicine, Addiction Medicine (Licence: RI MD15837) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: RI MD15837) |
| Enumeration Date | 2014-05-27 |
| Last Update Date | 2021-05-13 |