| NPI | 1871540435 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QA0401X Family Medicine, Addiction Medicine (Licence: ND PT15145) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: ND PT15145) |
| 207P00000X Emergency Medicine (Licence: WA MD00042009) | |
| 207RA0401X Internal Medicine, Addiction Medicine (Licence: ND PT15145) | |
| Enumeration Date | 2006-05-28 |
| Last Update Date | 2022-11-10 |