| NPI | 1619915824 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | |
| Primary Taxonomy | 207LA0401X Anesthesiology Addiction Medicine (Licence: GA 071681) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: GA 071681) |
| 207LP2900X Anesthesiology Pain Medicine (Licence: GA 071681) | |
| Enumeration Date | 2006-06-02 |
| Last Update Date | 2023-03-07 |