| NPI | 1376751271 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: WI 63432) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MI 4301086410) |
| 207L00000X Anesthesiology (Licence: ND 11188) | |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: MI 4301086410) | |
| Enumeration Date | 2007-05-21 |
| Last Update Date | 2015-02-06 |