| NPI | 1083752471 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LA0401X Anesthesiology, Addiction Medicine (Licence: GA 56463) |
| Additional Taxonomies | 2083A0300X Preventive Medicine, Addiction Medicine (Licence: GA 56463) |
| Enumeration Date | 2007-02-01 |
| Last Update Date | 2024-09-17 |