| NPI | 1902973811 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RA0401X Internal Medicine, Addiction Medicine (Licence: CA G77334) |
| Additional Taxonomies | 2084P0802X Psychiatry & Neurology, Addiction Psychiatry (Licence: CA G77334) |
| Enumeration Date | 2006-11-29 |
| Last Update Date | 2021-11-29 |