| NPI | 1124225552 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: SC 29814) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: SC 29814) |
| Enumeration Date | 2007-06-29 |
| Last Update Date | 2016-08-15 |