| NPI | 1821089764 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME75691) |
| Additional Taxonomies | 207RS0012X Internal Medicine, Sleep Medicine (Licence: FL ME75691) |
| 207RA0401X Internal Medicine, Addiction Medicine (Licence: FL ME75691) | |
| Enumeration Date | 2005-10-31 |
| Last Update Date | 2010-08-18 |