| NPI | 1144742420 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083A0300X Preventive Medicine, Addiction Medicine (Licence: CA a158220) |
| Additional Taxonomies | 2083A0300X Preventive Medicine, Addiction Medicine (Licence: TN 75968) |
| Enumeration Date | 2017-07-08 |
| Last Update Date | 2026-05-05 |