| NPI | 1285662635 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QA0401X Family Medicine, Addiction Medicine (Licence: FL ME67749) |
| Additional Taxonomies | 2083A0300X Preventive Medicine, Addiction Medicine (Licence: FL ME67749) |
| Enumeration Date | 2006-06-28 |
| Last Update Date | 2024-03-01 |