| NPI | 1063589935 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RA0401X Internal Medicine, Addiction Medicine (Licence: NY 170233) |
| Additional Taxonomies | 207RA0401X Internal Medicine, Addiction Medicine (Licence: CA A46120) |
| 207RA0401X Internal Medicine, Addiction Medicine (Licence: WA md60665946) | |
| Enumeration Date | 2006-11-29 |
| Last Update Date | 2021-06-09 |