| NPI | 1255509576 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: MD D74728) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CA A100606) |
| 207L00000X Anesthesiology (Licence: WA MD60193722) | |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: OH 57.019241) | |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: VA 0101257227) | |
| Enumeration Date | 2008-02-20 |
| Last Update Date | 2017-04-04 |