| NPI | 1235392127 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: WI 68111) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: NC 2013-00473) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: CT 48208) | |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: SC 32947) | |
| Enumeration Date | 2008-07-09 |
| Last Update Date | 2018-02-28 |