| NPI | 1851740708 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA A162085) |
| Additional Taxonomies | 207QA0401X Family Medicine, Addiction Medicine (Licence: CA A162085) |
| Enumeration Date | 2016-06-10 |
| Last Update Date | 2025-10-06 |