| NPI | 1508088196 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: AZ 42864) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: CO DR.0066661) |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2021-06-09 |