| NPI | 1053439489 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RA0401X Internal Medicine Addiction Medicine (Licence: IN 020055262A) |
| Additional Taxonomies | 207RA0401X Internal Medicine Addiction Medicine (Licence: VA 0102203803) |
| 207RA0401X Internal Medicine Addiction Medicine (Licence: LA 021805) | |
| Enumeration Date | 2007-03-26 |
| Last Update Date | 2018-04-24 |