| NPI | 1447543772 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: AR E-9821) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: KY R2702) |
| Enumeration Date | 2011-05-19 |
| Last Update Date | 2018-01-10 |