| NPI | 1467454322 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084A0401X Psychiatry & Neurology, Addiction Medicine (Licence: FL ME127853) |
| Additional Taxonomies | 207LA0401X Anesthesiology, Addiction Medicine (Licence: FL ME127853) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: FL ME127853) | |
| Enumeration Date | 2005-08-11 |
| Last Update Date | 2022-08-19 |