NPI | 1851884522 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207QA0401X Family Medicine, Addiction Medicine (Licence: IL 036.156620) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 036.156620) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2018-06-07 |
Last Update Date | 2022-10-12 |