| NPI | 1073590170 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: AL 19518) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: GA 18129) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: FL ME69047) | |
| Enumeration Date | 2005-12-29 |
| Last Update Date | 2007-10-25 |