| NPI | 1669590352 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RA0401X Internal Medicine, Addiction Medicine (Licence: MI 4301067395) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301067395) |
| Enumeration Date | 2007-03-27 |
| Last Update Date | 2019-06-13 |