| NPI | 1801013792 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: SC 31245) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: SC TL31245) |
| 207LC0200X Anesthesiology, Critical Care Medicine (Licence: SC TL31245) | |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: SC TL31245) | |
| Enumeration Date | 2007-04-20 |
| Last Update Date | 2021-03-19 |