| NPI | 1467848218 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME133076) | 
| Additional Taxonomies | 207RA0401X Internal Medicine, Addiction Medicine (Licence: FL ME133076) | 
| Enumeration Date | 2015-04-08 | 
| Last Update Date | 2023-03-02 |