| NPI | 1467558577 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: NC 2009-01794)  | 
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NC 2009-01794)  | 
| 208VP0000X  (Licence: NC 2009-01794)  | |
| Enumeration Date | 2006-09-15 | 
| Last Update Date | 2013-06-17 |