| NPI | 1710129986 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: LA 310432) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CA A141197) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: CA A141197) | |
| Enumeration Date | 2009-04-02 |
| Last Update Date | 2018-11-16 |