| NPI | 1184605461 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MD D0041055) |
| Additional Taxonomies | 207LP2900X Anesthesiology Pain Medicine (Licence: MD D0041055) |
| Enumeration Date | 2005-11-14 |
| Last Update Date | 2018-08-30 |