| NPI | 1629398912 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AZ 45475) |
| Additional Taxonomies | 207PT0002X Emergency Medicine Medical Toxicology (Licence: AZ 45475) |
| 207PT0002X Emergency Medicine Medical Toxicology (Licence: OR MD221429) | |
| 207PT0002X Emergency Medicine Medical Toxicology (Licence: TX U9545) | |
| 207PT0002X Emergency Medicine Medical Toxicology (Licence: FL ME165028) | |
| 2083A0300X Preventive Medicine Addiction Medicine (Licence: OR MD221429) | |
| 2083A0300X Preventive Medicine Addiction Medicine (Licence: AZ 45475) | |
| 2083A0300X Preventive Medicine Addiction Medicine (Licence: FL ME165028) | |
| 2083A0300X Preventive Medicine Addiction Medicine (Licence: TX U9545) | |
| Enumeration Date | 2010-06-09 |
| Last Update Date | 2024-08-02 |