| NPI | 1568456408 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084A0401X Psychiatry & Neurology, Addiction Medicine (Licence: FL Trn22146) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL me135984) |
| 207R00000X Internal Medicine (Licence: NH 8450) | |
| 207RA0401X Internal Medicine, Addiction Medicine (Licence: FL ME135984) | |
| Enumeration Date | 2005-09-07 |
| Last Update Date | 2019-03-22 |