| NPI | 1164521142 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: NV 8515) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CA G57732) |
| Enumeration Date | 2006-09-22 |
| Last Update Date | 2021-07-20 |