| NPI | 1538396932 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology Pain Medicine (Licence: WA MD60668626) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NE 26089) |
| 207L00000X Anesthesiology (Licence: WA MD60668626) | |
| 207LP2900X Anesthesiology Pain Medicine (Licence: NE 26089) | |
| 207LP2900X Anesthesiology Pain Medicine (Licence: WA 60668626) | |
| Enumeration Date | 2009-06-12 |
| Last Update Date | 2021-02-05 |