NPI | 1730208166 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: MI 4301088594) |
Additional Taxonomies | 207RA0401X Internal Medicine, Addiction Medicine (Licence: MI 4301088594) |
Enumeration Date | 2007-03-28 |
Last Update Date | 2025-05-27 |