| NPI | 1417121179 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology Pain Medicine (Licence: CT 047383) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NH 13811) |
| Enumeration Date | 2008-04-14 |
| Last Update Date | 2009-05-11 |