| NPI | 1134454747 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: OK 37103) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: PA MD447692) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: CA A107667) | |
| 208VP0000X (Licence: NY 261727) | |
| Enumeration Date | 2009-10-15 |
| Last Update Date | 2020-11-04 |