| NPI | 1780643189 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RA0401X Internal Medicine, Addiction Medicine (Licence: FL ME95023) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME95023) | 
| Enumeration Date | 2006-03-23 | 
| Last Update Date | 2011-11-22 |