| NPI | 1609956838 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WI 34583-020) |
| Additional Taxonomies | 207RA0401X Internal Medicine, Addiction Medicine (Licence: KY 40429) |
| Enumeration Date | 2006-10-16 |
| Last Update Date | 2016-01-25 |