| NPI | 1487635090 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: GA 036225) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: GA 036225) |
| Enumeration Date | 2005-11-10 |
| Last Update Date | 2010-06-24 |