| NPI | 1013911585 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CT 032767) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: CT 032767) |
| Enumeration Date | 2005-06-11 |
| Last Update Date | 2007-11-08 |