| NPI | 1992720817 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CO 22799) |
| Additional Taxonomies | 207RA0401X Internal Medicine, Addiction Medicine (Licence: CO 22799) |
| Enumeration Date | 2006-07-13 |
| Last Update Date | 2007-07-08 |