| NPI | 1770817108 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WI 84654) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MD D0078687) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: WI 84654) | |
| Enumeration Date | 2009-10-02 |
| Last Update Date | 2024-12-12 |