| NPI | 1265425235 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: VT 042-0014642) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CT 042894) |
| 207L00000X Anesthesiology (Licence: PA MD462742) | |
| 207LC0200X Anesthesiology, Critical Care Medicine (Licence: PA MD462742) | |
| 207LC0200X Anesthesiology, Critical Care Medicine (Licence: OH 35.094297) | |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: PA MD462742) | |
| Enumeration Date | 2005-08-25 |
| Last Update Date | 2020-03-03 |