| NPI | 1386648160 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: TN 26298) |
| Additional Taxonomies | 174400000X Specialist (Licence: TN md26298) |
| Enumeration Date | 2005-06-09 |
| Last Update Date | 2019-12-16 |