| NPI | 1285893990 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CO 33984) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MT 11042) |
| 207L00000X Anesthesiology (Licence: ND 6334) | |
| 207L00000X Anesthesiology (Licence: NE 20466) | |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: CO 33984) | |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: MT 11042) | |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: ND 6334) | |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: NE 20466) | |
| Enumeration Date | 2008-06-06 |
| Last Update Date | 2008-06-06 |