| NPI | 1598730152 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083A0300X Preventive Medicine, Addiction Medicine (Licence: MN 31091) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MN 31091) |
| Enumeration Date | 2006-02-17 |
| Last Update Date | 2019-06-11 |