| NPI | 1821651282 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RA0401X Internal Medicine Addiction Medicine (Licence: TN 67663) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: TN 67663) |
| 207R00000X Internal Medicine (Licence: TN 67663) | |
| Enumeration Date | 2019-04-20 |
| Last Update Date | 2024-09-23 |