| NPI | 1922063528 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: NE 18959) |
| Additional Taxonomies | 207RA0401X Internal Medicine, Addiction Medicine (Licence: NE 18959) |
| Enumeration Date | 2006-04-18 |
| Last Update Date | 2023-08-16 |