| NPI | 1992083885 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RA0401X Internal Medicine, Addiction Medicine (Licence: NY 272914) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 272914) |
| Enumeration Date | 2011-07-27 |
| Last Update Date | 2023-03-02 |