| NPI | 1407114713 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: HI DOS 1497) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: HI DOS 1497) |
| Enumeration Date | 2012-04-25 |
| Last Update Date | 2013-07-01 |