| NPI | 1255433819 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083A0300X Preventive Medicine, Addiction Medicine (Licence: WA MD60736138) |
| Additional Taxonomies | 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine (Licence: WA 60736138) |
| Enumeration Date | 2006-09-03 |
| Last Update Date | 2023-02-24 |