| NPI | 1225024656 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: MA 220264) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: MT 10523) |
| Enumeration Date | 2005-09-21 |
| Last Update Date | 2011-07-12 |