| NPI | 1588842744 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology Pain Medicine (Licence: MN 67142) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CA A115174) |
| 207L00000X Anesthesiology (Licence: MT 19712) | |
| 207LP2900X Anesthesiology Pain Medicine (Licence: WI 66490) | |
| Enumeration Date | 2008-02-08 |
| Last Update Date | 2022-06-03 |