| NPI | 1477875094 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology Pain Medicine (Licence: ID M-12480) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: ID M-12480) |
| 207L00000X Anesthesiology (Licence: AZ R71475) | |
| Enumeration Date | 2010-02-23 |
| Last Update Date | 2016-02-09 |