| NPI | 1619003415 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: CA G76734) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CA G76734) |
| Enumeration Date | 2007-02-26 |
| Last Update Date | 2009-03-19 |