| NPI | 1174518799 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MD D0036495) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: MD D0036495) |
| 207L00000X Anesthesiology (Licence: VA 0101033599) | |
| Enumeration Date | 2005-09-20 |
| Last Update Date | 2012-09-28 |