| NPI | 1124091947 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TN MD38581) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: TN 38178) |
| Enumeration Date | 2006-02-10 |
| Last Update Date | 2012-01-10 |