| NPI | 1215068960 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: OR MD182776) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MD D0053387) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: MD D0053387) | |
| Enumeration Date | 2007-03-07 |
| Last Update Date | 2018-10-10 |