| NPI | 1487619383 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NC 9500942) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: SC 17870) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: SC 17870) | |
| Enumeration Date | 2006-04-20 |
| Last Update Date | 2020-08-12 |