NPI | 1083761670 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207RA0401X Internal Medicine, Addiction Medicine (Licence: CA A43785) |
Additional Taxonomies | 174400000X Specialist (Licence: CA A43785) |
Enumeration Date | 2007-01-04 |
Last Update Date | 2024-08-27 |