| NPI | 1457393811 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology Pain Medicine (Licence: ID M5826) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: ID M5826) |
| Enumeration Date | 2006-06-12 |
| Last Update Date | 2011-06-08 |