| NPI | 1891094025 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME36340) |
| Additional Taxonomies | 207RH0002X Internal Medicine, Hospice and Palliative Medicine (Licence: FL ME36340) |
| 207RA0401X Internal Medicine, Addiction Medicine (Licence: FL ME36340) | |
| Enumeration Date | 2011-03-28 |
| Last Update Date | 2016-09-06 |