| NPI | 1215967666 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA MD066834L) |
| Additional Taxonomies | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: NJ 25MA07305800) |
| 207QA0401X Family Medicine, Addiction Medicine (Licence: DE C10006321) | |
| 2083X0100X Preventive Medicine, Occupational Medicine (Licence: DE C10006321) | |
| Enumeration Date | 2006-07-03 |
| Last Update Date | 2016-04-05 |