| NPI | 1316991631 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MD D30317) |
| Additional Taxonomies | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: MD D72023) |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: MD D30317) | |
| Enumeration Date | 2006-05-20 |
| Last Update Date | 2007-07-08 |