| NPI | 1205298502 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083A0300X Preventive Medicine Addiction Medicine (Licence: MS 26981) |
| Additional Taxonomies | 2083P0901X Preventive Medicine Public Health & General Preventive Medicine (Licence: MS 26981) |
| 2084P2900X Psychiatry & Neurology Pain Medicine (Licence: MS 26981) | |
| Enumeration Date | 2016-03-25 |
| Last Update Date | 2021-09-13 |