| NPI | 1962604728 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: PA OS015644) |
| Additional Taxonomies | 207LA0401X Anesthesiology, Addiction Medicine (Licence: OH 34.009137CTR) |
| 208D00000X General Practice (Licence: OH 34.009137CTR) | |
| 207LA0401X Anesthesiology, Addiction Medicine (Licence: PA OS015644) | |
| Enumeration Date | 2007-06-04 |
| Last Update Date | 2024-01-25 |