| NPI | 1225261324 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: TX Q3833) |
| Additional Taxonomies | 208600000X Surgery (Licence: IL 125057068) |
| 207L00000X Anesthesiology (Licence: WI 56537) | |
| Enumeration Date | 2009-08-24 |
| Last Update Date | 2017-01-10 |