| NPI | 1457341307 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RA0401X Internal Medicine, Addiction Medicine (Licence: FL ME0060612) |
| Additional Taxonomies | 207QA0401X Family Medicine, Addiction Medicine (Licence: FL ME0060612) |
| 207RA0401X Internal Medicine, Addiction Medicine (Licence: FL 60612) | |
| 208000000X Pediatrics (Licence: FL ME60612) | |
| 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: FL ME0060612) | |
| 2084A0401X Psychiatry & Neurology, Addiction Medicine (Licence: FL ME60612) | |
| Enumeration Date | 2005-10-24 |
| Last Update Date | 2023-08-30 |