| NPI | 1023340700 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MI 4301095729) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 336.085504) |
| 207RA0401X Internal Medicine Addiction Medicine (Licence: MI 4301095729) | |
| Enumeration Date | 2010-02-05 |
| Last Update Date | 2023-11-27 |