| NPI | 1053497750 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: SC 5061) |
| Additional Taxonomies | 207LC0200X Anesthesiology Critical Care Medicine (Licence: SC 5061) |
| 207LP2900X Anesthesiology Pain Medicine (Licence: SC 5061) | |
| Enumeration Date | 2006-10-27 |
| Last Update Date | 2007-07-08 |