| NPI | 1346241312 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: SC 899) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA B42186) |
| 207LP2900X Anesthesiology Pain Medicine (Licence: PA B42186) | |
| Enumeration Date | 2005-08-02 |
| Last Update Date | 2017-01-24 |