| NPI | 1952377566 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QA0401X Family Medicine, Addiction Medicine (Licence: MI 100005) |
| Additional Taxonomies | 207RA0401X Internal Medicine, Addiction Medicine (Licence: MI 100005) |
| Enumeration Date | 2006-02-23 |
| Last Update Date | 2009-06-30 |