| NPI | 1285077404 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology Pain Medicine (Licence: WI 69530) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: WI 69530) |
| 207L00000X Anesthesiology (Licence: CA 20A15228) | |
| Enumeration Date | 2013-04-08 |
| Last Update Date | 2018-08-07 |