| NPI | 1174086748 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA A194708) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: WI 75283) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: WI 75283) | |
| Enumeration Date | 2019-04-10 |
| Last Update Date | 2024-06-10 |