| NPI | 1841486149 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CT 032912) |
| Additional Taxonomies | 2083A0300X Preventive Medicine, Addiction Medicine (Licence: CT 032912) |
| Enumeration Date | 2007-09-20 |
| Last Update Date | 2020-12-07 |