| NPI | 1760449938 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2083A0300X Preventive Medicine, Addiction Medicine (Licence: WI 60259-20) |
| Additional Taxonomies | 2083A0300X Preventive Medicine, Addiction Medicine (Licence: IN 01062968A) |
| 207Q00000X Family Medicine (Licence: WI 60259-20) | |
| 2083A0300X Preventive Medicine, Addiction Medicine (Licence: AZ 64981) | |
| 2083A0300X Preventive Medicine, Addiction Medicine (Licence: IL 036084729) | |
| Enumeration Date | 2006-04-28 |
| Last Update Date | 2025-09-23 |