| NPI | 1164500658 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology Pain Medicine (Licence: CA A86301) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CA A86301) |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2007-07-26 |