| NPI | 1982630307 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083A0300X Preventive Medicine, Addiction Medicine (Licence: VA 0101034240) |
| Additional Taxonomies | 208600000X Surgery (Licence: VA 0101034240) |
| Enumeration Date | 2006-06-25 |
| Last Update Date | 2024-06-06 |