| NPI | 1891749107 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: SC 85467) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: AL 00026609) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: AL 26609) | |
| Enumeration Date | 2006-05-20 |
| Last Update Date | 2021-11-03 |