NPI | 1184776155 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 9500489) |
Additional Taxonomies | 207QA0401X Family Medicine, Addiction Medicine (Licence: NC 9500489) |
Enumeration Date | 2007-01-18 |
Last Update Date | 2023-06-08 |