| NPI | 1033505342 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: DC MD048514) |
| Additional Taxonomies | 207RA0401X Internal Medicine, Addiction Medicine (Licence: DC MD048514) |
| 208000000X Pediatrics (Licence: DC MD048514) | |
| Enumeration Date | 2015-04-13 |
| Last Update Date | 2020-07-13 |