NPI | 1831181981 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 179838) |
Additional Taxonomies | 207QA0401X Family Medicine, Addiction Medicine (Licence: NY 179838) |
Enumeration Date | 2005-08-16 |
Last Update Date | 2019-10-09 |