| NPI | 1104876283 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA A97004) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MO 2006005745) |
| 207LA0401X Anesthesiology Addiction Medicine (Licence: MO 2006005745) | |
| 207LC0200X Anesthesiology Critical Care Medicine (Licence: MO 2006005745) | |
| 207LP2900X Anesthesiology Pain Medicine (Licence: MO 2006005745) | |
| 207L00000X Anesthesiology (Licence: TX L2876) | |
| Enumeration Date | 2006-05-11 |
| Last Update Date | 2017-03-15 |