| NPI | 1639166523 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QA0401X Family Medicine, Addiction Medicine (Licence: CA A55575) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CA A55575) |
| Enumeration Date | 2005-10-05 |
| Last Update Date | 2024-12-03 |