| NPI | 1316957871 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MD d0036846) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MD d0036846) |
| 207RA0401X Internal Medicine, Addiction Medicine (Licence: MD d0036846) | |
| Enumeration Date | 2006-08-08 |
| Last Update Date | 2016-03-21 |