| NPI | 1538120803 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LA0401X Anesthesiology, Addiction Medicine (Licence: FL ME54511) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL ME54511) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: FL ME54511) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: FL ME54511) | |
| Enumeration Date | 2006-03-28 |
| Last Update Date | 2017-03-07 |