| NPI | 1093747628 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: ME MD14178) |
| Additional Taxonomies | 2083A0300X Preventive Medicine, Addiction Medicine (Licence: ME MD014178) |
| Enumeration Date | 2006-07-06 |
| Last Update Date | 2022-11-20 |