| NPI | 1619374527 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083A0300X Preventive Medicine Addiction Medicine (Licence: PA OS004799L) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA OS-004799-L) |
| 207RA0401X Internal Medicine Addiction Medicine (Licence: PA OS004799L) | |
| Enumeration Date | 2014-11-21 |
| Last Update Date | 2023-10-17 |