| NPI | 1477590404 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: TN MD17057) |
| Additional Taxonomies | 208VP0000X (Licence: TN MD17057) |
| Enumeration Date | 2006-05-31 |
| Last Update Date | 2016-01-05 |