| NPI | 1013098821 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RA0401X Internal Medicine, Addiction Medicine (Licence: WI 51152) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WI 51152) |
| 207QA0401X Family Medicine, Addiction Medicine (Licence: WI 51152) | |
| Enumeration Date | 2006-10-18 |
| Last Update Date | 2024-03-15 |