| NPI | 1124061072 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MD D0059979) |
| Additional Taxonomies | 207LP2900X Anesthesiology Pain Medicine (Licence: MD D0059979) |
| Enumeration Date | 2006-06-14 |
| Last Update Date | 2008-04-07 |