| NPI | 1245394246 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: KY MD16062) |
| Additional Taxonomies | 207RA0401X Internal Medicine, Addiction Medicine (Licence: KY 16062) |
| Enumeration Date | 2006-12-21 |
| Last Update Date | 2015-06-24 |