| NPI | 1255650263 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 265045) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: VT 042.0013219) |
| 207PT0002X Emergency Medicine, Medical Toxicology (Licence: NY 265045) | |
| 207RA0401X Internal Medicine, Addiction Medicine (Licence: NY 265045) | |
| Enumeration Date | 2010-06-01 |
| Last Update Date | 2025-01-03 |