| NPI | 1619037074 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RA0401X Internal Medicine, Addiction Medicine (Licence: FL ME53812) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL ME53812) |
| Enumeration Date | 2006-12-08 |
| Last Update Date | 2018-04-18 |