| NPI | 1417148024 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QA0401X Family Medicine, Addiction Medicine (Licence: IN 02004594A) |
| Additional Taxonomies | 207QA0401X Family Medicine, Addiction Medicine (Licence: VA 0102203536) |
| 207QA0401X Family Medicine, Addiction Medicine (Licence: PA OS014185) | |
| 207QA0401X Family Medicine, Addiction Medicine (Licence: MS 21086) | |
| Enumeration Date | 2007-08-08 |
| Last Update Date | 2021-07-07 |