| NPI | 1861557472 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: AZ 38018)  | 
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CA A94800)  | 
| 207LP2900X Anesthesiology, Pain Medicine (Licence: CA A94800)  | |
| Enumeration Date | 2006-12-26 | 
| Last Update Date | 2023-03-07 |