| NPI | 1962781021 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RA0401X Internal Medicine, Addiction Medicine (Licence: MA 274479) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 274479) |
| Enumeration Date | 2011-08-08 |
| Last Update Date | 2020-05-22 |