| NPI | 1437132644 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX J4328) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL ME91371) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: TX J4328) | |
| Enumeration Date | 2005-11-22 |
| Last Update Date | 2007-07-08 |