| NPI | 1295994358 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: SD 8425) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NE 5780) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: SD 8425) | |
| Enumeration Date | 2008-06-04 |
| Last Update Date | 2017-12-06 |