| NPI | 1487880084 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MA 250317) |
| Additional Taxonomies | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: MA 250317) |
| 2083A0300X Preventive Medicine, Addiction Medicine (Licence: MA 250317) | |
| Enumeration Date | 2009-06-09 |
| Last Update Date | 2023-09-13 |