| NPI | 1447546593 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MI 4301098448) | 
| Additional Taxonomies | 207RA0401X Internal Medicine, Addiction Medicine (Licence: MI 4301098448) | 
| Enumeration Date | 2011-06-27 | 
| Last Update Date | 2023-04-04 |