| NPI | 1801200704 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084A0401X Psychiatry & Neurology, Addiction Medicine (Licence: UT 12082954-1205) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IL 125065449) |
| 207P00000X Emergency Medicine (Licence: IN 01081809A) | |
| Enumeration Date | 2014-06-18 |
| Last Update Date | 2025-05-22 |