| NPI | 1477567998 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RA0401X Internal Medicine, Addiction Medicine (Licence: FL ME164916) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX R2655) |
| 2084A0401X Psychiatry & Neurology, Addiction Medicine (Licence: LA MD.08784R) | |
| 208D00000X General Practice (Licence: LA 08784R) | |
| Enumeration Date | 2006-07-28 |
| Last Update Date | 2023-11-21 |