| NPI | 1336108984 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MA 220442) |
| Additional Taxonomies | 207RA0401X Internal Medicine, Addiction Medicine (Licence: MA 220442) |
| Enumeration Date | 2006-03-22 |
| Last Update Date | 2022-11-17 |