| NPI | 1174636724 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME90567) |
| Additional Taxonomies | 207QA0401X Family Medicine, Addiction Medicine (Licence: FL ME90567) |
| Enumeration Date | 2006-08-17 |
| Last Update Date | 2021-07-16 |