| NPI | 1801904636 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: AL 12074) |
| Additional Taxonomies | 207RA0401X Internal Medicine, Addiction Medicine (Licence: AL 12074) |
| 207RH0002X Internal Medicine, Hospice and Palliative Medicine (Licence: AL 12074) | |
| Enumeration Date | 2006-08-29 |
| Last Update Date | 2019-01-30 |