| NPI | 1841289758 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NC 36588) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: NC 36588) |
| 207L00000X Anesthesiology (Licence: SC 29428) | |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: SC 29428) | |
| Enumeration Date | 2005-10-14 |
| Last Update Date | 2018-08-02 |