| NPI | 1497991624 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MI 4301501615) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: MD D79046) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: MI 4301501615) | |
| 207L00000X Anesthesiology (Licence: MD D79046) | |
| Enumeration Date | 2008-12-17 |
| Last Update Date | 2020-09-03 |