| NPI | 1386957280 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2083A0300X Preventive Medicine, Addiction Medicine (Licence: FL ME131226) |
| Additional Taxonomies | 207QA0401X Family Medicine, Addiction Medicine (Licence: FL ME131226) |
| 207RA0401X Internal Medicine, Addiction Medicine (Licence: FL ME131226) | |
| 208VP0000X (Licence: FL ME131226) | |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: FL ME131226) | |
| 207LA0401X Anesthesiology, Addiction Medicine (Licence: FL ME131226) | |
| Enumeration Date | 2010-07-20 |
| Last Update Date | 2020-03-04 |