| NPI | 1306885454 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TN 26622) |
| Additional Taxonomies | 2084A0401X Psychiatry & Neurology, Addiction Medicine (Licence: TN 26622) |
| Enumeration Date | 2006-06-05 |
| Last Update Date | 2019-06-20 |