| NPI | 1710920939 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MI 4301065872) |
| Additional Taxonomies | 207RA0401X Internal Medicine Addiction Medicine (Licence: MI 4301065872) |
| Enumeration Date | 2006-06-14 |
| Last Update Date | 2024-05-21 |