NPI | 1841411378 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine (Licence: CA A40525) |
Additional Taxonomies | 2084A0401X Psychiatry & Neurology, Addiction Medicine (Licence: CA A40525) |
Enumeration Date | 2007-05-01 |
Last Update Date | 2025-09-11 |