| NPI | 1346773082 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QA0401X Family Medicine, Addiction Medicine (Licence: TN 3603) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TN 3603) |
| 2083A0300X Preventive Medicine, Addiction Medicine (Licence: TN 3603) | |
| 208D00000X General Practice (Licence: TN 3603) | |
| Enumeration Date | 2017-04-10 |
| Last Update Date | 2024-03-11 |