| NPI | 1083926232 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology Pain Medicine (Licence: CA 20A14690) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MI 5101018777) |
| Enumeration Date | 2010-07-04 |
| Last Update Date | 2018-10-15 |