| NPI | 1861487878 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: NV 8402) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: AZ 26067) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: CA G62878) | |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: UT 5937479-1205) | |
| Enumeration Date | 2005-09-15 |
| Last Update Date | 2011-10-19 |