| NPI | 1972090280 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083A0300X Preventive Medicine, Addiction Medicine (Licence: CA A173657) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A173657) |
| Enumeration Date | 2018-04-23 |
| Last Update Date | 2024-06-24 |