| NPI | 1679550792 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CO 27260) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: CO 27260) |
| Enumeration Date | 2005-12-29 |
| Last Update Date | 2021-08-06 |