| NPI | 1952466567 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: WA MD60109781) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: CA A89079) |
| 207L00000X Anesthesiology (Licence: CA A89079) | |
| Enumeration Date | 2006-12-26 |
| Last Update Date | 2025-06-30 |