| NPI | 1548249519 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: IA 18366) |
| Additional Taxonomies | 207RA0401X Internal Medicine, Addiction Medicine (Licence: IA 18366) |
| Enumeration Date | 2006-01-10 |
| Last Update Date | 2007-10-16 |