| NPI | 1467549030 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QA0401X Family Medicine, Addiction Medicine (Licence: CA G35504) |
| Additional Taxonomies | 207QA0401X Family Medicine, Addiction Medicine (Licence: WV 12102) |
| 207QA0401X Family Medicine, Addiction Medicine (Licence: DE C1-0004019) | |
| Enumeration Date | 2006-10-06 |
| Last Update Date | 2021-11-19 |