| NPI | 1538239520 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RA0401X Internal Medicine, Addiction Medicine (Licence: CO 0058849) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 036119004) |
| 207R00000X Internal Medicine (Licence: CA A95435) | |
| Enumeration Date | 2006-11-08 |
| Last Update Date | 2018-11-07 |