| NPI | 1033346580 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MA 249705) |
| Additional Taxonomies | 207RA0401X Internal Medicine, Addiction Medicine (Licence: MA 249705) |
| Enumeration Date | 2009-06-11 |
| Last Update Date | 2022-09-01 |