| NPI | 1265724280 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MA 266486) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: MA 266486) |
| Enumeration Date | 2011-05-10 |
| Last Update Date | 2019-09-03 |