| NPI | 1336119577 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology Pain Medicine (Licence: MS 19518) |
| Additional Taxonomies | 207LP2900X Anesthesiology Pain Medicine (Licence: TN 51029) |
| Enumeration Date | 2006-01-23 |
| Last Update Date | 2018-05-24 |