| NPI | 1083692982 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology Pain Medicine (Licence: KY 48908) |
| Additional Taxonomies | 207LP2900X Anesthesiology Pain Medicine (Licence: NY 231723) |
| Enumeration Date | 2006-01-03 |
| Last Update Date | 2018-08-10 |