| NPI | 1235166851 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME0048473) |
| Additional Taxonomies | 207RA0401X Internal Medicine, Addiction Medicine (Licence: FL ME48473) |
| Enumeration Date | 2006-06-27 |
| Last Update Date | 2015-04-23 |