| NPI | 1427390186 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA A134437) |
| Additional Taxonomies | 2083A0300X Preventive Medicine Addiction Medicine (Licence: CA A134437) |
| Enumeration Date | 2013-03-20 |
| Last Update Date | 2019-10-01 |