| NPI | 1427118629 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: IA 36931) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: NE 24245) |
| 208D00000X General Practice (Licence: IA 36931) | |
| Enumeration Date | 2006-12-11 |
| Last Update Date | 2011-10-11 |