NPI | 1255347878 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: PA MD423076) |
Additional Taxonomies | 207RA0401X Internal Medicine, Addiction Medicine (Licence: PA MD423076) |
Enumeration Date | 2006-08-01 |
Last Update Date | 2023-08-17 |