| NPI | 1710938535 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NC 30982) |
| Additional Taxonomies | 207RA0401X Internal Medicine, Addiction Medicine (Licence: NC 30982) |
| Enumeration Date | 2006-05-15 |
| Last Update Date | 2023-04-21 |