NPI | 1902929193 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2083A0300X Preventive Medicine, Addiction Medicine (Licence: CA C41583) |
Additional Taxonomies | 207LA0401X Anesthesiology, Addiction Medicine (Licence: CA C41583) |
Enumeration Date | 2007-04-10 |
Last Update Date | 2024-01-11 |