| NPI | 1275746026 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology Pain Medicine (Licence: GA 67565) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: VA 0101248777) |
| Enumeration Date | 2007-05-08 |
| Last Update Date | 2019-05-16 |