NPI | 1144856451 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207RA0401X Internal Medicine, Addiction Medicine (Licence: IL 036.169801) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 036.169801) |
Enumeration Date | 2020-03-18 |
Last Update Date | 2025-06-17 |