| NPI | 1437136686 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: PA OS00504L) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: PA OS005094L) |
| Enumeration Date | 2005-12-29 |
| Last Update Date | 2012-03-13 |