NPI | 1255446688 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207RA0401X Internal Medicine, Addiction Medicine (Licence: CA 61-0572) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A74560) |
Enumeration Date | 2006-08-19 |
Last Update Date | 2021-09-21 |