| NPI | 1871528455 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: NM 2002-0462) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CA 51715) |
| 207L00000X Anesthesiology (Licence: CO 40658) | |
| 207L00000X Anesthesiology (Licence: TX G0247) | |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: NC 2003-00422) | |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: SC MD36735) | |
| Enumeration Date | 2006-07-11 |
| Last Update Date | 2022-05-31 |