| NPI | 1265429807 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CO DR.0061426) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: SC 85362) |
| 207L00000X Anesthesiology (Licence: GA 029797) | |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: GA 029797) | |
| Enumeration Date | 2005-09-29 |
| Last Update Date | 2024-06-10 |