| NPI | 1649809955 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RA0401X Internal Medicine, Addiction Medicine (Licence: FL ME163572) |
| Additional Taxonomies | 208VP0000X (Licence: FL ME163572) |
| 207R00000X Internal Medicine (Licence: FL ME163572) | |
| Enumeration Date | 2020-04-07 |
| Last Update Date | 2025-11-10 |