| NPI | 1508064668 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RA0401X Internal Medicine, Addiction Medicine (Licence: PA OS014132) |
| Additional Taxonomies | 207LA0401X Anesthesiology, Addiction Medicine (Licence: PA OS014132) |
| Enumeration Date | 2007-07-10 |
| Last Update Date | 2017-05-26 |