| NPI | 1982640140 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TN MD0039603) |
| Additional Taxonomies | 207RA0401X Internal Medicine, Addiction Medicine (Licence: TN 39603) |
| 2083A0300X Preventive Medicine, Addiction Medicine (Licence: TN 39603) | |
| 208M00000X Hospitalist (Licence: TN 39603) | |
| Enumeration Date | 2006-06-22 |
| Last Update Date | 2023-09-20 |