| NPI | 1649297292 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: GA 055994) |
| Additional Taxonomies | 207LA0401X Anesthesiology, Addiction Medicine (Licence: GA 055994) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: GA 055994) | |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2019-02-19 |