| NPI | 1376981571 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: SD 10764) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: IA R-9804) |
| Enumeration Date | 2013-06-10 |
| Last Update Date | 2018-08-15 |