| NPI | 1457525842 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MI 4301035231) |
| Additional Taxonomies | 207QA0401X Family Medicine, Addiction Medicine (Licence: MI 4301035231) |
| 208U00000X Clinical Pharmacology (Licence: MI 4301035231) | |
| Enumeration Date | 2008-04-16 |
| Last Update Date | 2008-04-16 |