NPI | 1225028020 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207L00000X Anesthesiology (Licence: MI 4301503103) |
Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: WV 20666) |
207LP2900X Anesthesiology, Pain Medicine (Licence: OH 35078000) | |
Enumeration Date | 2005-10-24 |
Last Update Date | 2020-12-17 |