| 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) | |
| 2083P0901X Preventive Medicine Public Health & General Preventive Medicine (Licence: CT 67102) | |
| 208D00000X General Practice (Licence: TN 3603) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-04-10 |
| Last Update Date | 2022-07-15 |