| NPI | 1154486769 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: NV 14407) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NV 14407) |
| 207L00000X Anesthesiology (Licence: CA A95206) | |
| 207L00000X Anesthesiology (Licence: WA MD60071790) | |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: CA A95206) | |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: WA MD60071790) | |
| Enumeration Date | 2006-12-26 |
| Last Update Date | 2019-01-29 |