| NPI | 1639125404 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: KY 18917) |
| Additional Taxonomies | 2083A0300X Preventive Medicine, Addiction Medicine (Licence: KY 18917) |
| Enumeration Date | 2006-05-25 |
| Last Update Date | 2023-03-22 |