| 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 |