| NPI | 1083024590 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: AR E-13242) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX 583388) |
| 207RA0401X Internal Medicine, Addiction Medicine (Licence: TX 583388) | |
| Enumeration Date | 2014-05-06 |
| Last Update Date | 2021-08-16 |