| NPI | 1184618852 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083A0300X Preventive Medicine, Addiction Medicine (Licence: NH 9985) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NH 9985) |
| 207QA0401X Family Medicine, Addiction Medicine (Licence: NH 9985) | |
| Enumeration Date | 2005-09-08 |
| Last Update Date | 2021-04-20 |