NPI | 1912290859 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084A0401X Psychiatry & Neurology, Addiction Medicine (Licence: NC 00202) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TN MD0000051650) |
Enumeration Date | 2011-05-25 |
Last Update Date | 2023-05-22 |