| NPI | 1477554632 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LH0002X Anesthesiology, Hospice and Palliative Medicine (Licence: TN 20003) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TN 20003) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: TN 20003) | |
| Enumeration Date | 2005-08-09 |
| Last Update Date | 2017-03-15 |