| NPI | 1841251105 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QA0401X Family Medicine Addiction Medicine (Licence: CA G47843) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA G47843) |
| Enumeration Date | 2006-03-28 |
| Last Update Date | 2024-04-29 |