| NPI | 1144541475 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QA0401X Family Medicine, Addiction Medicine (Licence: NC 2015-02149) |
| Additional Taxonomies | 103TA0400X Psychologist, Addiction (Substance Use Disorder) (Licence: NC 2015-02149) |
| 207Q00000X Family Medicine (Licence: NC 2015-02149) | |
| 207QH0002X Family Medicine, Hospice and Palliative Medicine (Licence: NC 2015-02149) | |
| Enumeration Date | 2010-06-22 |
| Last Update Date | 2023-06-26 |