NPI | 1881667046 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207QA0401X Family Medicine Addiction Medicine (Licence: IN 01045645A) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: IN 01045645A) |
Enumeration Date | 2006-02-08 |
Last Update Date | 2017-04-14 |