| NPI | 1285741918 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: GA 78113) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NC 009500636) |
| 207LC0200X Anesthesiology, Critical Care Medicine (Licence: NC 009500636) | |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: NC 009500636) | |
| 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: NC 009500636) | |
| Enumeration Date | 2006-08-25 |
| Last Update Date | 2018-12-10 |