NPI | 1013906833 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: GA 83482) |
Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: GA 83482) |
2084A0401X Psychiatry & Neurology, Addiction Medicine (Licence: GA 83482) | |
207L00000X Anesthesiology (Licence: WA MD60035970) | |
Enumeration Date | 2005-10-14 |
Last Update Date | 2020-08-07 |