| NPI | 1316903198 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MI 4301061729) |
| Additional Taxonomies | 207RA0401X Internal Medicine, Addiction Medicine (Licence: MI 4301061729) |
| 208000000X Pediatrics (Licence: MI 4301061729) | |
| Enumeration Date | 2006-04-21 |
| Last Update Date | 2023-02-09 |