| NPI | 1811098304 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: TX M4512) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301082914) |
| 207RA0401X Internal Medicine, Addiction Medicine (Licence: TX M4512) | |
| Enumeration Date | 2006-09-26 |
| Last Update Date | 2013-02-21 |