| NPI | 1326097809 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RA0401X Internal Medicine, Addiction Medicine (Licence: MI 4301087247) |
| Additional Taxonomies | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: MI 4301087247) |
| Enumeration Date | 2006-05-10 |
| Last Update Date | 2022-09-22 |