| NPI | 1831367762 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA 20A9369) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: CA 20A9369) |
| 207RA0401X Internal Medicine, Addiction Medicine (Licence: CA 20A9369) | |
| Enumeration Date | 2008-02-13 |
| Last Update Date | 2014-07-21 |