| NPI | 1902167497 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: WA MD60833574) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CO DR.0064518) |
| Enumeration Date | 2012-05-31 |
| Last Update Date | 2023-02-14 |