NPI | 1891878427 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: LA 320747) |
Additional Taxonomies | 2083A0300X Preventive Medicine, Addiction Medicine (Licence: LA 320747) |
Enumeration Date | 2006-10-24 |
Last Update Date | 2024-02-24 |