| NPI | 1851316673 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: IA 40433) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MO 105718) |
| 207LP2900X Anesthesiology Pain Medicine (Licence: IA 40433) | |
| 207LP3000X Anesthesiology Pediatric Anesthesiology (Licence: IA 40433) | |
| Enumeration Date | 2006-07-13 |
| Last Update Date | 2012-09-06 |