| NPI | 1053334219 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: VA 0101257630) |
| Additional Taxonomies | 207RA0401X Internal Medicine Addiction Medicine (Licence: VA 0101257630) |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2023-08-14 |