| NPI | 1003868951 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MO 2007016516) |
| Additional Taxonomies | 207LA0401X Anesthesiology, Addiction Medicine (Licence: IA 3687) |
| Enumeration Date | 2006-05-17 |
| Last Update Date | 2020-03-10 |