| NPI | 1972009785 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 319435-1) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A166747) |
| 207RA0401X Internal Medicine, Addiction Medicine (Licence: NY 319435-1) | |
| Enumeration Date | 2018-04-02 |
| Last Update Date | 2024-01-27 |