NPI | 1518907146 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207RA0401X Internal Medicine Addiction Medicine (Licence: OH 35064391) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35064391) |
Enumeration Date | 2006-06-08 |
Last Update Date | 2021-07-20 |