| NPI | 1811121924 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083A0300X Preventive Medicine Addiction Medicine (Licence: TN 2663) |
| Additional Taxonomies | 207LP2900X Anesthesiology Pain Medicine (Licence: GA 071791) |
| 207RA0401X Internal Medicine Addiction Medicine (Licence: TN 2663) | |
| 207RA0401X Internal Medicine Addiction Medicine (Licence: GA 071791) | |
| 2083A0300X Preventive Medicine Addiction Medicine (Licence: GA 71791) | |
| Enumeration Date | 2009-05-05 |
| Last Update Date | 2023-07-20 |