| NPI | 1790753937 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME88332) |
| Additional Taxonomies | 207RA0401X Internal Medicine, Addiction Medicine (Licence: FL ME88332) |
| 207RI0200X Internal Medicine, Infectious Disease (Licence: FL ME 88332) | |
| Enumeration Date | 2006-03-14 |
| Last Update Date | 2024-10-02 |