NPI | 1881080638 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2083A0300X Preventive Medicine, Addiction Medicine (Licence: CA A144483) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA A144483) |
Enumeration Date | 2015-04-08 |
Last Update Date | 2024-02-29 |