| NPI | 1134197817 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MO r9d25) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: MO R9D25) |
| Enumeration Date | 2006-03-09 |
| Last Update Date | 2014-01-30 |