| NPI | 1386637858 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: MD D0063781) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA MD035098E) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: PA MD035098E) | |
| Enumeration Date | 2005-08-30 |
| Last Update Date | 2010-07-16 |