| NPI | 1518957901 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA A75514) |
| Additional Taxonomies | 207LA0401X Anesthesiology Addiction Medicine (Licence: CA A75514) |
| Enumeration Date | 2005-10-26 |
| Last Update Date | 2021-11-29 |