| NPI | 1073599403 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NC 000024102) |
| Additional Taxonomies | 207LP2900X Anesthesiology Pain Medicine (Licence: NC 24102) |
| Enumeration Date | 2005-12-19 |
| Last Update Date | 2017-09-11 |