| NPI | 1063791853 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MI 4301098454) |
| Additional Taxonomies | 207LA0401X Anesthesiology, Addiction Medicine (Licence: AR E-12723) |
| 207LC0200X Anesthesiology, Critical Care Medicine (Licence: MI 4301098454) | |
| 207LC0200X Anesthesiology, Critical Care Medicine (Licence: AR E-12723) | |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: MI 4301098454) | |
| 207LA0401X Anesthesiology, Addiction Medicine (Licence: MI 4301098454) | |
| 207L00000X Anesthesiology (Licence: AR E-12723) | |
| Enumeration Date | 2011-08-10 |
| Last Update Date | 2023-08-11 |