| NPI | 1255446688 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RA0401X Internal Medicine, Addiction Medicine (Licence: CA 61-0572) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A74560) |
| Enumeration Date | 2006-08-19 |
| Last Update Date | 2021-09-21 |