| NPI | 1700922846 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083A0300X Preventive Medicine, Addiction Medicine (Licence: CT 027141) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: CT 027141) |
| Enumeration Date | 2007-01-29 |
| Last Update Date | 2024-02-15 |