| NPI | 1619641693 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME163245) |
| Additional Taxonomies | 207RA0000X Internal Medicine, Adolescent Medicine (Licence: FL ME163245) |
| 207RA0401X Internal Medicine, Addiction Medicine (Licence: FL ME163245) | |
| 207RG0300X Internal Medicine, Geriatric Medicine (Licence: FL ME163245) | |
| Enumeration Date | 2021-08-04 |
| Last Update Date | 2024-03-14 |