NPI | 1073590170 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: AL 19518) |
Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: GA 18129) |
207LP2900X Anesthesiology, Pain Medicine (Licence: FL ME69047) | |
Enumeration Date | 2005-12-29 |
Last Update Date | 2007-10-25 |