| NPI | 1851325708 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: VA 0101039368) |
| Additional Taxonomies | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: VA 0101039368) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: VA 0101039368) | |
| Enumeration Date | 2006-07-10 |
| Last Update Date | 2016-02-01 |