NPI | 1720512692 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: MA 286904) |
Additional Taxonomies | 207RA0401X Internal Medicine, Addiction Medicine (Licence: MA 286904) |
Enumeration Date | 2017-04-17 |
Last Update Date | 2022-08-19 |