| NPI | 1750391777 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2083A0300X Preventive Medicine, Addiction Medicine (Licence: GA 31731) |
| Additional Taxonomies | 174400000X Specialist (Licence: GA 031731) |
| 207L00000X Anesthesiology (Licence: GA 31731) | |
| 208VP0000X (Licence: GA 31731) | |
| Enumeration Date | 2006-08-09 |
| Last Update Date | 2021-05-25 |