| NPI | 1033326335 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: TN 45964)  | 
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MI 4301086857)  | 
| Enumeration Date | 2007-05-17 | 
| Last Update Date | 2020-06-26 |