| NPI | 1336125285 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA A98953) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NV 10978) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: TN 43477) | |
| Enumeration Date | 2005-12-21 |
| Last Update Date | 2008-07-07 |