| NPI | 1396123576 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PT0002X Emergency Medicine, Medical Toxicology (Licence: NY 292827) |
| Additional Taxonomies | 2083A0300X Preventive Medicine, Addiction Medicine (Licence: NY 292827) |
| Enumeration Date | 2015-05-08 |
| Last Update Date | 2024-03-18 |