| NPI | 1669766135 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083A0300X Preventive Medicine, Addiction Medicine (Licence: MA 262035) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MA 262035) |
| 207P00000X Emergency Medicine (Licence: MI 5101019345) | |
| Enumeration Date | 2011-06-02 |
| Last Update Date | 2023-01-25 |