| NPI | 1831121649 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084A0401X Psychiatry & Neurology, Addiction Medicine (Licence: HI MD10122) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: HI MD10122) |
| Enumeration Date | 2006-07-06 |
| Last Update Date | 2016-01-12 |