| NPI | 1669613816 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084A0401X Psychiatry & Neurology, Addiction Medicine (Licence: CA A103097) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CA A103097) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: CA A103097) | |
| Enumeration Date | 2009-03-18 |
| Last Update Date | 2024-07-01 |