| NPI | 1730150541 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: NC 2005-01843) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NC 2005-01843) |
| 207L00000X Anesthesiology (Licence: VA 0101233479) | |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: VA 0101233479) | |
| Enumeration Date | 2006-01-30 |
| Last Update Date | 2015-10-16 |