| NPI | 1619941994 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: GA 78517) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: VA 0101234616) |
| 207L00000X Anesthesiology (Licence: CA A102588) | |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: CA A102588) | |
| Enumeration Date | 2006-02-14 |
| Last Update Date | 2020-05-26 |