| NPI | 1487732855 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WI 50803-20) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WI 50803-20) |
| 2083A0300X Preventive Medicine, Addiction Medicine (Licence: WI 50803-20) | |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2023-03-06 |