| NPI | 1700835063 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RA0401X Internal Medicine, Addiction Medicine (Licence: CO DR.0074012) |
| Additional Taxonomies | 207RA0401X Internal Medicine, Addiction Medicine (Licence: AZ 8171) |
| Enumeration Date | 2006-05-06 |
| Last Update Date | 2025-05-21 |