NPI | 1235166851 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME0048473) |
Additional Taxonomies | 207RA0401X Internal Medicine, Addiction Medicine (Licence: FL ME48473) |
Enumeration Date | 2006-06-27 |
Last Update Date | 2015-04-23 |