| NPI | 1356369805 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP3000X Anesthesiology Pediatric Anesthesiology (Licence: MO 101260) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MO 101260) |
| 208VP0000X Pain Medicine Pain Medicine (Licence: MO 101260) | |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2025-04-17 |