| NPI | 1629085105 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CO 27403) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: CO 27403) |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2012-03-13 |