| NPI | 1144263690 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: SC 28779) |
| Additional Taxonomies | 208VP0000X Pain Medicine Pain Medicine (Licence: SC 28779) |
| Enumeration Date | 2006-06-13 |
| Last Update Date | 2012-06-01 |