| NPI | 1407803893 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: NM MD2015-0259) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: OR MD20589) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: ND 13018) | |
| Enumeration Date | 2006-05-30 |
| Last Update Date | 2020-02-05 |