| NPI | 1003037037 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083A0300X Preventive Medicine, Addiction Medicine (Licence: WA 61-2555) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA ML20008655) |
| Enumeration Date | 2007-05-01 |
| Last Update Date | 2024-07-09 |