NPI | 1265469175 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: PA MD053632L) |
Additional Taxonomies | 207RA0401X Internal Medicine, Addiction Medicine (Licence: PA MD053632L) |
Enumeration Date | 2006-06-27 |
Last Update Date | 2023-02-10 |