| NPI | 1487759049 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: VA 0101255448) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: WV 22370) |
| 207L00000X Anesthesiology (Licence: AR E-5228) | |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: VA 0101255448) | |
| Enumeration Date | 2006-09-14 |
| Last Update Date | 2024-04-19 |