NPI | 1245693811 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: OR MD193727) |
Additional Taxonomies | 207RA0401X Internal Medicine, Addiction Medicine (Licence: OR MD193727) |
Enumeration Date | 2016-03-31 |
Last Update Date | 2025-05-27 |