| NPI | 1780640383 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RA0401X Internal Medicine, Addiction Medicine (Licence: MA 51339) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CT 68197) |
| 207R00000X Internal Medicine (Licence: MA 51339) | |
| 207RA0401X Internal Medicine, Addiction Medicine (Licence: CT 68197) | |
| Enumeration Date | 2006-04-22 |
| Last Update Date | 2022-10-18 |