NPI | 1275820797 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: LA 310567) |
Additional Taxonomies | 207RA0401X Internal Medicine, Addiction Medicine (Licence: LA 310567) |
Enumeration Date | 2011-07-05 |
Last Update Date | 2021-11-08 |