| NPI | 1265403158 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: VA 0101221482) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: VA 0101221482) |
| 207RA0401X Internal Medicine, Addiction Medicine (Licence: VA 0101221482) | |
| Enumeration Date | 2006-01-30 |
| Last Update Date | 2022-08-03 |