NPI | 1548313950 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME0038971) |
Additional Taxonomies | 207RA0401X Internal Medicine, Addiction Medicine (Licence: FL ME38971) |
Enumeration Date | 2007-01-19 |
Last Update Date | 2020-05-27 |