| NPI | 1093058604 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA 20A18850) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: UT 12931506-8204) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: NE 1216) | |
| Enumeration Date | 2013-04-02 |
| Last Update Date | 2022-08-04 |