| NPI | 1215917885 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RA0401X Internal Medicine, Addiction Medicine (Licence: ME 16503) |
| Additional Taxonomies | 207RA0000X Internal Medicine, Adolescent Medicine (Licence: ME 16503) |
| Enumeration Date | 2006-01-19 |
| Last Update Date | 2019-04-27 |