| NPI | 1427017730 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NC 29695) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: SC 14786) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: SC 14786) | |
| Enumeration Date | 2006-03-23 |
| Last Update Date | 2012-08-09 |