NPI | 1851873079 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207QA0401X Family Medicine, Addiction Medicine (Licence: MO 2025040388) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: AL DO.2708) |
208M00000X Hospitalist (Licence: AL DO.2708) | |
Enumeration Date | 2018-09-04 |
Last Update Date | 2025-09-17 |