| NPI | 1003891300 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology Pain Medicine (Licence: GA 044757) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: GA 44757) |
| Enumeration Date | 2005-12-08 |
| Last Update Date | 2015-11-23 |