| NPI | 1740579176 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: NH 18235) |
| Additional Taxonomies | 207RA0401X Internal Medicine, Addiction Medicine (Licence: NH 18235) |
| Enumeration Date | 2011-04-06 |
| Last Update Date | 2019-06-10 |