| NPI | 1023209228 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: AZ 4766) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: CO CDR.0000846) |
| Enumeration Date | 2007-08-05 |
| Last Update Date | 2021-05-10 |