| NPI | 1811984818 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME77670) |
| Additional Taxonomies | 207RA0401X Internal Medicine, Addiction Medicine (Licence: FL me77670) |
| Enumeration Date | 2005-10-04 |
| Last Update Date | 2016-01-07 |