| NPI | 1235442757 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: FL OS12007) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA OT012617) |
| Enumeration Date | 2010-07-26 |
| Last Update Date | 2013-11-21 |