| NPI | 1477649218 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RA0401X Internal Medicine, Addiction Medicine (Licence: MS 13406) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MS 13406) |
| 208D00000X General Practice (Licence: MS 13406) | |
| Enumeration Date | 2006-10-05 |
| Last Update Date | 2012-07-10 |