| NPI | 1245290790 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LA0401X Anesthesiology, Addiction Medicine (Licence: CO 41306) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CO 41306) |
| Enumeration Date | 2006-03-27 |
| Last Update Date | 2018-04-16 |