| NPI | 1861472441 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207LA0401X Anesthesiology, Addiction Medicine (Licence: OH 35.055910) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: OH 35055910) |
| 207RA0401X Internal Medicine, Addiction Medicine (Licence: DE C1-0006970) | |
| Enumeration Date | 2006-01-19 |
| Last Update Date | 2021-12-15 |