| NPI | 1831346733 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083A0300X Preventive Medicine, Addiction Medicine (Licence: MI 4301102323) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 4301102323) |
| 207P00000X Emergency Medicine (Licence: PA MD441036) | |
| Enumeration Date | 2008-08-21 |
| Last Update Date | 2026-03-12 |