| NPI | 1013069962 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MA 230791) |
| Additional Taxonomies | 207RA0401X Internal Medicine, Addiction Medicine (Licence: MA 230791) |
| 2083A0300X Preventive Medicine, Addiction Medicine (Licence: MA 230791) | |
| Enumeration Date | 2007-01-18 |
| Last Update Date | 2024-03-05 |