| NPI | 1043240377 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL M0095598) |
| Additional Taxonomies | 2083A0300X Preventive Medicine, Addiction Medicine (Licence: FL ME95598) |
| Enumeration Date | 2006-07-03 |
| Last Update Date | 2026-04-02 |