| NPI | 1962452292 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: AZ 10046) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CA C51066) |
| 207L00000X Anesthesiology (Licence: KY 33476) | |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: CA C51066) | |
| Enumeration Date | 2006-05-10 |
| Last Update Date | 2022-07-21 |