NPI | 1649808171 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207RA0401X Internal Medicine, Addiction Medicine (Licence: WA OP61569545) |
Additional Taxonomies | 207RA0401X Internal Medicine, Addiction Medicine (Licence: OR DO214799) |
Enumeration Date | 2020-03-30 |
Last Update Date | 2024-08-07 |