| NPI | 1194790881 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: SC MD29477) |
| Additional Taxonomies | 207RA0401X Internal Medicine, Addiction Medicine (Licence: NC 38962) |
| 207RG0300X Internal Medicine, Geriatric Medicine (Licence: NC 38962) | |
| 207R00000X Internal Medicine (Licence: NC 38962) | |
| Enumeration Date | 2006-02-17 |
| Last Update Date | 2019-12-05 |