| NPI | 1891804712 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NV 8585) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CA A55388) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: NV 8585) | |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2021-07-20 |