NPI | 1164497053 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207RA0401X Internal Medicine, Addiction Medicine (Licence: OH 35.080110) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 820583807) |
Enumeration Date | 2006-02-22 |
Last Update Date | 2019-01-03 |