| NPI | 1376513143 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 176961) |
| Additional Taxonomies | 207PE0005X Emergency Medicine, Undersea and Hyperbaric Medicine (Licence: NY 176961) |
| 207PT0002X Emergency Medicine, Medical Toxicology (Licence: NY 176961) | |
| 207RA0401X Internal Medicine, Addiction Medicine (Licence: NY 176961) | |
| Enumeration Date | 2006-01-25 |
| Last Update Date | 2017-04-05 |