| NPI | 1811983737 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: SC 52195) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: LA 08276R) |
| 207L00000X Anesthesiology (Licence: NC 31455) | |
| 207L00000X Anesthesiology (Licence: GA 040015) | |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: NC 31455) | |
| Enumeration Date | 2005-09-26 |
| Last Update Date | 2022-01-21 |