| NPI | 1295730760 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: KY 26059) |
| Additional Taxonomies | 208VP0000X Pain Medicine, Pain Medicine (Licence: KY 26059) |
| Enumeration Date | 2005-06-20 |
| Last Update Date | 2011-02-24 |