| NPI | 1811253909 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RA0401X Internal Medicine, Addiction Medicine (Licence: CA A130657) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A130657) |
| 208M00000X Hospitalist (Licence: CA A130657) | |
| Enumeration Date | 2012-04-03 |
| Last Update Date | 2023-05-05 |