| NPI | 1801968268 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: GU M001403) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: GU M001403) |
| 207LC0200X Anesthesiology, Critical Care Medicine (Licence: GU M001403) | |
| Enumeration Date | 2006-11-14 |
| Last Update Date | 2011-02-23 |