| NPI | 1346353687 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083A0300X Preventive Medicine, Addiction Medicine (Licence: MA 249400) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MA 249400) |
| 207Q00000X Family Medicine (Licence: ME 1858) | |
| 207QA0401X Family Medicine, Addiction Medicine (Licence: MA 249400) | |
| Enumeration Date | 2006-08-17 |
| Last Update Date | 2025-02-09 |