| NPI | 1710975586 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CO DR.0039525) |
| Additional Taxonomies | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: CO 39525) |
| 207L00000X Anesthesiology (Licence: NE 26018) | |
| 207L00000X Anesthesiology (Licence: WY 6553A) | |
| Enumeration Date | 2005-10-06 |
| Last Update Date | 2013-06-06 |