NPI | 1710986955 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: MI 5101013130) |
Additional Taxonomies | 207RA0401X Internal Medicine, Addiction Medicine (Licence: MI 5101013130) |
Enumeration Date | 2005-07-19 |
Last Update Date | 2024-07-24 |