| NPI | 1083680417 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RA0401X Internal Medicine Addiction Medicine (Licence: WI 41661-21) |
| Additional Taxonomies | 207QA0401X Family Medicine Addiction Medicine (Licence: WI 41661) |
| Enumeration Date | 2006-02-26 |
| Last Update Date | 2018-08-22 |