| NPI | 1699979518 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WI 2537) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NC 2015-01387) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: NC 2015-01387) | |
| Enumeration Date | 2007-06-13 |
| Last Update Date | 2020-01-15 |