| NPI | 1851598130 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NC 201201284) |
| Additional Taxonomies | 207LA0401X Anesthesiology, Addiction Medicine (Licence: NC 201201284) |
| Enumeration Date | 2007-06-29 |
| Last Update Date | 2022-02-22 |