| NPI | 1306864947 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QA0401X Family Medicine, Addiction Medicine (Licence: PA OS015580) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: DE C2-0012469) |
| 207Q00000X Family Medicine (Licence: IN 02003097A) | |
| 207Q00000X Family Medicine (Licence: PA OS015580) | |
| 207QA0401X Family Medicine, Addiction Medicine (Licence: DE C2-0012469) | |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2023-03-21 |