NPI | 1902838105 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: LA 020189) |
Additional Taxonomies | 207RA0401X Internal Medicine, Addiction Medicine (Licence: LA MD.020189) |
Enumeration Date | 2006-07-07 |
Last Update Date | 2022-12-01 |