| NPI | 1194748798 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CO 47223) |
| Additional Taxonomies | 207LP2900X Anesthesiology Pain Medicine (Licence: CA A83962) |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2020-01-06 |