NPI | 1700014529 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA 20A12210) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 5101018484) |
207RA0401X Internal Medicine, Addiction Medicine (Licence: CA 20A12210) | |
Enumeration Date | 2009-07-01 |
Last Update Date | 2025-08-26 |