| NPI | 1861620908 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: CA A122860) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NE 27371) |
| 207R00000X Internal Medicine (Licence: NE 6092) | |
| Enumeration Date | 2009-06-28 |
| Last Update Date | 2013-08-26 |