| NPI | 1790706000 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: CA 4672) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: MI 5101007636) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: FL FLOS0006613) | |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: MO 2006012480) | |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: MS 20436) | |
| Enumeration Date | 2006-07-21 |
| Last Update Date | 2019-04-09 |