| NPI | 1194954214 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NE 26912) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NE 6140) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: CA a123583) | |
| Enumeration Date | 2009-07-10 |
| Last Update Date | 2013-07-09 |