| NPI | 1417956418 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: NH 14220) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MA 160820) |
| Enumeration Date | 2005-07-20 |
| Last Update Date | 2014-08-20 |