| NPI | 1376644401 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LA0401X Anesthesiology, Addiction Medicine (Licence: WV 20823) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: WV 20823) |
| Enumeration Date | 2006-09-25 |
| Last Update Date | 2023-09-12 |