| NPI | 1174064315 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OR MD199352) |
| Additional Taxonomies | 207RA0401X Internal Medicine, Addiction Medicine (Licence: OR MD199352) |
| Enumeration Date | 2017-03-20 |
| Last Update Date | 2021-07-20 |