| NPI | 1356421085 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083A0300X Preventive Medicine, Addiction Medicine (Licence: MA 226489) |
| Additional Taxonomies | 2083A0300X Preventive Medicine, Addiction Medicine (Licence: PA MD483977) |
| 2083A0300X Preventive Medicine, Addiction Medicine (Licence: VA 0101279518) | |
| Enumeration Date | 2006-10-17 |
| Last Update Date | 2024-03-21 |