| NPI | 1134373962 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology Pain Medicine (Licence: NC 20070372) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NC 2007-00372) |
| Enumeration Date | 2008-11-06 |
| Last Update Date | 2021-12-07 |