| NPI | 1023049483 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RA0401X Internal Medicine, Addiction Medicine (Licence: CA G61164) |
| Additional Taxonomies | 207QA0401X Family Medicine, Addiction Medicine (Licence: CA G61164) |
| 208600000X Surgery (Licence: CA G61164) | |
| 208M00000X Hospitalist (Licence: CA G61164) | |
| Enumeration Date | 2006-07-05 |
| Last Update Date | 2018-10-11 |