| NPI | 1417040742 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: KY 16440) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: KY 16440) |
| Enumeration Date | 2006-09-30 |
| Last Update Date | 2015-09-18 |