NPI | 1376723981 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: CT 66872) |
Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA MT195756) |
207LP2900X Anesthesiology, Pain Medicine (Licence: WA MD60272371) | |
Enumeration Date | 2007-11-12 |
Last Update Date | 2021-10-19 |