| 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 |