| NPI | 1174880165 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NH 17389) |
| Additional Taxonomies | 2083A0300X Preventive Medicine Addiction Medicine (Licence: NH 17389) |
| Enumeration Date | 2012-04-16 |
| Last Update Date | 2023-02-09 |