| NPI | 1326049396 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: WV 0101243964) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: WV 21736) |
| Enumeration Date | 2005-08-02 |
| Last Update Date | 2014-10-16 |