| NPI | 1184822264 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: PA OS015378) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL OS9548) |
| 207L00000X Anesthesiology (Licence: PA OS015378) | |
| Enumeration Date | 2007-07-10 |
| Last Update Date | 2013-08-20 |