NPI | 1467949529 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: TN 65030) |
Additional Taxonomies | 207QA0401X Family Medicine Addiction Medicine (Licence: TN 65030) |
Enumeration Date | 2018-04-15 |
Last Update Date | 2024-01-24 |