| NPI | 1841511037 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: KY 48968) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: GA 4204) |
| 207LC0200X Anesthesiology Critical Care Medicine (Licence: GA 072985) | |
| 207LP2900X Anesthesiology Pain Medicine (Licence: OK 31227) | |
| Enumeration Date | 2010-06-22 |
| Last Update Date | 2022-10-05 |