| NPI | 1962516500 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RA0401X Internal Medicine, Addiction Medicine (Licence: AZ AZ20797) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: AZ AZ20797) |
| Enumeration Date | 2006-08-19 |
| Last Update Date | 2022-08-02 |