| NPI | 1376528414 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MO 102394) |
| Additional Taxonomies | 208VP0000X Pain Medicine, Pain Medicine (Licence: MO 102394) |
| Enumeration Date | 2005-12-13 |
| Last Update Date | 2008-07-02 |