| NPI | 1780692574 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: GA 033364) |
| Additional Taxonomies | 207LA0401X Anesthesiology Addiction Medicine (Licence: GA 033364) |
| 207LP2900X Anesthesiology Pain Medicine (Licence: GA 033364) | |
| Enumeration Date | 2006-08-04 |
| Last Update Date | 2015-01-22 |