| NPI | 1801022959 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RA0401X Internal Medicine, Addiction Medicine (Licence: VT 042.0015508) |
| Additional Taxonomies | 207RA0401X Internal Medicine, Addiction Medicine (Licence: NH 21905) |
| 207RA0401X Internal Medicine, Addiction Medicine (Licence: MA 289813) | |
| 207RA0401X Internal Medicine, Addiction Medicine (Licence: ME MD26314) | |
| Enumeration Date | 2009-06-03 |
| Last Update Date | 2024-03-06 |