| NPI | 1629285150 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NV DO2555) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: SC 1488) |
| 207RA0401X Internal Medicine, Addiction Medicine (Licence: NC 2011-00286) | |
| 2083A0300X Preventive Medicine, Addiction Medicine (Licence: SC 1488) | |
| Enumeration Date | 2007-05-16 |
| Last Update Date | 2023-10-25 |