| NPI | 1770502106 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RA0401X Internal Medicine, Addiction Medicine (Licence: NH 9799) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NH 9799) |
| 207P00000X Emergency Medicine (Licence: ME MD20347) | |
| 207R00000X Internal Medicine (Licence: NH 9799) | |
| 208000000X Pediatrics (Licence: NH 9799) | |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2020-04-17 |