| NPI | 1780146910 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RA0401X Internal Medicine, Addiction Medicine (Licence: NY 316289) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 316289) |
| Enumeration Date | 2019-04-05 |
| Last Update Date | 2024-09-30 |