| NPI | 1396060604 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RA0401X Internal Medicine Addiction Medicine (Licence: WY 49412A) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WY 9412A) |
| Enumeration Date | 2010-03-30 |
| Last Update Date | 2022-10-24 |