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 |