| NPI | 1306093877 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083A0300X Preventive Medicine, Addiction Medicine (Licence: TN 4418) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TN 4418) |
| Enumeration Date | 2008-08-26 |
| Last Update Date | 2021-07-28 |