NPI | 1316903198 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: MI 4301061729) |
Additional Taxonomies | 207RA0401X Internal Medicine, Addiction Medicine (Licence: MI 4301061729) |
208000000X Pediatrics (Licence: MI 4301061729) | |
Enumeration Date | 2006-04-21 |
Last Update Date | 2023-02-09 |