| NPI | 1881683522 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RA0401X Internal Medicine, Addiction Medicine (Licence: MD D31064) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MD D31064) |
| 207R00000X Internal Medicine (Licence: MD D31064) | |
| Enumeration Date | 2005-10-16 |
| Last Update Date | 2013-03-21 |