| NPI | 1275843914 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: FL OS16143) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: VA 0102203028) |
| Enumeration Date | 2010-10-15 |
| Last Update Date | 2021-05-12 |