| NPI | 1053364141 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: NC 2018-00794) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: WA MD60287283) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: VA 0101241466) | |
| 207R00000X Internal Medicine (Licence: MI 4301080279) | |
| Enumeration Date | 2006-05-18 |
| Last Update Date | 2018-12-01 |