| NPI | 1952419764 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MA 221431) |
| Additional Taxonomies | 207RA0401X Internal Medicine, Addiction Medicine (Licence: MA 221431) |
| Enumeration Date | 2006-08-29 |
| Last Update Date | 2022-10-11 |