| NPI | 1265587992 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TN MD27576) |
| Additional Taxonomies | 207LP2900X Anesthesiology Pain Medicine (Licence: TN 27576) |
| Enumeration Date | 2007-01-24 |
| Last Update Date | 2018-03-17 |