| NPI | 1255313631 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: GA 060334) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MD H0062660) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: MD H0062660) | |
| Enumeration Date | 2005-11-19 |
| Last Update Date | 2020-12-01 |