| NPI | 1336128545 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: AL 19429) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: AL MD 19429) |
| Enumeration Date | 2006-01-16 |
| Last Update Date | 2008-09-08 |