| NPI | 1629024328 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RA0401X Internal Medicine, Addiction Medicine (Licence: MA 153944) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MA 153944) |
| Enumeration Date | 2006-05-25 |
| Last Update Date | 2015-12-15 |