| NPI | 1699868786 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: VA 0101231597) |
| Additional Taxonomies | 207U00000X Nuclear Medicine (Licence: VA 07395) |
| 207RA0401X Internal Medicine, Addiction Medicine (Licence: VA 0101231597) | |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2024-05-24 |