NPI | 1023049483 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207RA0401X Internal Medicine, Addiction Medicine (Licence: CA G61164) |
Additional Taxonomies | 207QA0401X Family Medicine, Addiction Medicine (Licence: CA G61164) |
208600000X Surgery (Licence: CA G61164) | |
208M00000X Hospitalist (Licence: CA G61164) | |
Enumeration Date | 2006-07-05 |
Last Update Date | 2018-10-11 |