| NPI | 1841422797 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084A0401X Psychiatry & Neurology, Addiction Medicine (Licence: FL OS 10340) |
| Additional Taxonomies | 207QA0401X Family Medicine, Addiction Medicine (Licence: FL OS10340) |
| 207LA0401X Anesthesiology, Addiction Medicine (Licence: FL OS 10340) | |
| Enumeration Date | 2009-08-11 |
| Last Update Date | 2015-04-21 |