| NPI | 1164507182 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: SC 12270) |
| Additional Taxonomies | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: SC 12270) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: SC 12270) | |
| Enumeration Date | 2006-10-26 |
| Last Update Date | 2020-11-09 |