| NPI | 1578829016 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: CO DR.0061837) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MA 273793) |
| Enumeration Date | 2012-04-10 |
| Last Update Date | 2022-09-13 |