| NPI | 1265691653 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CO 48051) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CA A100087) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: CA A100087) | |
| Enumeration Date | 2008-06-02 |
| Last Update Date | 2012-08-06 |