NPI | 1275587727 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207QA0401X Family Medicine, Addiction Medicine (Licence: IL 036.147372) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: SD 10564) |
207Q00000X Family Medicine (Licence: SD 1119) | |
Enumeration Date | 2006-05-20 |
Last Update Date | 2018-09-21 |