NPI | 1992766638 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: OH 35057236) |
Additional Taxonomies | 207RA0401X Internal Medicine, Addiction Medicine (Licence: OH 35.057236) |
Enumeration Date | 2006-03-31 |
Last Update Date | 2023-06-22 |