| NPI | 1144562968 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MI 4301113814) |
| Additional Taxonomies | 207QA0401X Family Medicine Addiction Medicine (Licence: MI 4301113814) |
| Enumeration Date | 2013-03-19 |
| Last Update Date | 2023-04-18 |