| NPI | 1134154339 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: MS 11790) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MS 11790) |
| 207R00000X Internal Medicine (Licence: MS 11790) | |
| Enumeration Date | 2006-07-12 |
| Last Update Date | 2013-02-06 |