| NPI | 1912926718 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RA0401X Internal Medicine, Addiction Medicine (Licence: PA MD050257L) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MD050257L) |
| Enumeration Date | 2006-07-19 |
| Last Update Date | 2022-07-18 |