| NPI | 1104026509 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA A94850) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: CA A94850) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: WA MD00047699) | |
| Enumeration Date | 2007-07-23 |
| Last Update Date | 2021-11-29 |