| NPI | 1770834012 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: LA 300473) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: LA 300473) |
| 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: LA 300473) | |
| 207RA0401X Internal Medicine, Addiction Medicine (Licence: LA 300473) | |
| Enumeration Date | 2012-09-26 |
| Last Update Date | 2024-11-13 |