| NPI | 1043480932 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine (Licence: SC 33514) |
| Additional Taxonomies | 2083A0300X Preventive Medicine, Addiction Medicine (Licence: FL ME151894) |
| Enumeration Date | 2008-03-06 |
| Last Update Date | 2026-05-31 |