| NPI | 1215988498 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: OR MD10202) |
| Additional Taxonomies | 207LP2900X Anesthesiology Pain Medicine (Licence: OR MD10202) |
| Enumeration Date | 2006-05-13 |
| Last Update Date | 2007-10-15 |