| NPI | 1083678411 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: SC 37034) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: AL 266626) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: AL 26626) | |
| Enumeration Date | 2006-04-13 |
| Last Update Date | 2014-12-05 |