| NPI | 1144425075 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TN 42847) |
| Additional Taxonomies | 207QA0401X Family Medicine, Addiction Medicine (Licence: KY 41991) |
| 207Q00000X Family Medicine (Licence: KY 41991) | |
| 207QA0401X Family Medicine, Addiction Medicine (Licence: TN 42847) | |
| 2083A0300X Preventive Medicine, Addiction Medicine (Licence: TN 42847) | |
| Enumeration Date | 2007-06-20 |
| Last Update Date | 2023-03-21 |