| NPI | 1952511073 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MI 4301086163) |
| Additional Taxonomies | 207QA0401X Family Medicine, Addiction Medicine (Licence: MI 4301086163) |
| 2083A0300X Preventive Medicine, Addiction Medicine (Licence: MI 4301086163) | |
| Enumeration Date | 2007-05-24 |
| Last Update Date | 2024-01-16 |