| NPI | 1245408848 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: CT 049314) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MA 225473) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: MA 239512) | |
| Enumeration Date | 2008-02-15 |
| Last Update Date | 2010-11-23 |