| NPI | 1619052743 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: SC 27094)  | 
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: SC LL27094)  | 
| 207LC0200X Anesthesiology, Critical Care Medicine (Licence: SC 27094)  | |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: SC 27094)  | |
| Enumeration Date | 2006-10-26 | 
| Last Update Date | 2024-05-14 |