| NPI | 1346688975 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MA L-255652) |
| Additional Taxonomies | 207RA0401X Internal Medicine, Addiction Medicine (Licence: MA 267420) |
| Enumeration Date | 2013-06-05 |
| Last Update Date | 2025-08-15 |