| NPI | 1922259647 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084A0401X Psychiatry & Neurology, Addiction Medicine (Licence: FL me49592) |
| Additional Taxonomies | 207RA0401X Internal Medicine, Addiction Medicine (Licence: FL me49592) |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: FL me49592) | |
| Enumeration Date | 2008-10-01 |
| Last Update Date | 2010-02-05 |