| NPI | 1275642191 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RA0401X Internal Medicine, Addiction Medicine (Licence: ID M4860) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: ID m4860) |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2025-12-08 |