| NPI | 1699946996 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LA0401X Anesthesiology, Addiction Medicine (Licence: NC 32114) |
| Additional Taxonomies | 2083A0300X Preventive Medicine, Addiction Medicine (Licence: NC 32114) |
| 207L00000X Anesthesiology (Licence: NC 32114) | |
| Enumeration Date | 2008-03-14 |
| Last Update Date | 2026-04-15 |