| NPI | 1780664896 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: SC DO-979) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NC 9601128) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: SC DO-979) | |
| Enumeration Date | 2006-01-17 |
| Last Update Date | 2015-10-09 |