NPI | 1841844115 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208D00000X General Practice (Licence: CA G60750) |
Additional Taxonomies | 207LA0401X Anesthesiology, Addiction Medicine (Licence: CA G60750) |
Enumeration Date | 2019-07-25 |
Last Update Date | 2021-11-09 |