| NPI | 1356526917 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology Pain Medicine (Licence: LA MD.201366) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: AL 29506) |
| 207L00000X Anesthesiology (Licence: LA MD.201366) | |
| Enumeration Date | 2008-01-02 |
| Last Update Date | 2013-01-15 |