| NPI | 1013084821 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QA0401X Family Medicine, Addiction Medicine (Licence: CA G81561) |
| Additional Taxonomies | 207QA0401X Family Medicine, Addiction Medicine (Licence: CO 50616) |
| Enumeration Date | 2006-11-29 |
| Last Update Date | 2024-11-26 |