| NPI | 1417997990 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: TN MD20652) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TN MD20652) |
| Enumeration Date | 2006-06-06 |
| Last Update Date | 2016-03-03 |