NPI | 1851313399 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: MO 108125) |
Additional Taxonomies | 2083A0300X Preventive Medicine, Addiction Medicine (Licence: MO 108125) |
Enumeration Date | 2006-07-24 |
Last Update Date | 2024-11-06 |