NPI | 1750455259 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA G45704) |
Additional Taxonomies | 207RA0401X Internal Medicine, Addiction Medicine (Licence: CA G45704) |
Enumeration Date | 2006-11-17 |
Last Update Date | 2015-02-18 |