| NPI | 1316967375 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: ME 16124) |
| Additional Taxonomies | 2083A0300X Preventive Medicine, Addiction Medicine (Licence: ME 16124) |
| 2083A0300X Preventive Medicine, Addiction Medicine (Licence: NH 34702) | |
| Enumeration Date | 2006-07-20 |
| Last Update Date | 2025-09-10 |