| NPI | 1356326490 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NC 36589) |
| Additional Taxonomies | 207LA0401X Anesthesiology, Addiction Medicine (Licence: NC 36589) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: NC 36589) | |
| Enumeration Date | 2005-12-13 |
| Last Update Date | 2017-09-08 |