NPI | 1033297445 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: WV 2130) |
Additional Taxonomies | 207QA0401X Family Medicine, Addiction Medicine (Licence: WV 2130) |
Enumeration Date | 2006-11-02 |
Last Update Date | 2021-07-12 |