| NPI | 1962472894 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MA 157760) |
| Additional Taxonomies | 207RI0008X Internal Medicine, Hepatology (Licence: MA 157760) |
| 207RA0401X Internal Medicine, Addiction Medicine (Licence: MA 157760) | |
| Enumeration Date | 2006-01-24 |
| Last Update Date | 2007-07-08 |