NPI | 1568456408 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084A0401X Psychiatry & Neurology, Addiction Medicine (Licence: FL Trn22146) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL me135984) |
207R00000X Internal Medicine (Licence: NH 8450) | |
207RA0401X Internal Medicine, Addiction Medicine (Licence: FL ME135984) | |
Enumeration Date | 2005-09-07 |
Last Update Date | 2019-03-22 |