NPI | 1790883627 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207LP2900X Anesthesiology Pain Medicine (Licence: SC MMD.39240) |
Additional Taxonomies | 207L00000X Anesthesiology (Licence: WV 21895) |
207L00000X Anesthesiology (Licence: VA 0101242390) | |
207L00000X Anesthesiology (Licence: NC 2016-02291) | |
Enumeration Date | 2006-09-21 |
Last Update Date | 2022-08-04 |