| NPI | 1588694848 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084A0401X Psychiatry & Neurology, Addiction Medicine (Licence: MD D0062884) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: MD D0062884) |
| Enumeration Date | 2006-07-03 |
| Last Update Date | 2021-04-06 |