| NPI | 1407906613 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RA0401X Internal Medicine, Addiction Medicine (Licence: PA OS006067E) |
| Additional Taxonomies | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: PA OS006067E) |
| 2083X0100X Preventive Medicine, Occupational Medicine (Licence: PA OS006067E) | |
| Enumeration Date | 2007-01-11 |
| Last Update Date | 2018-04-10 |