| NPI | 1962504415 |
|---|---|
| Other Name | KEN WIANT |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207QA0401X Family Medicine Addiction Medicine (Licence: TX F8733) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX F8733) |
| Enumeration Date | 2006-09-05 |
| Last Update Date | 2007-08-18 |