| NPI | 1578646410 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NC 2009-01207) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: NC 2009-01207) |
| 207L00000X Anesthesiology (Licence: IA 3531) | |
| 207L00000X Anesthesiology (Licence: WI 49442-021) | |
| Enumeration Date | 2006-10-23 |
| Last Update Date | 2009-07-15 |