| NPI | 1225013642 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: PA MD042589L) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: PA MD042589L) |
| Enumeration Date | 2005-12-08 |
| Last Update Date | 2007-11-06 |