| NPI | 1487712162 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: OR MD126133) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MA 221921) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: OR MD126133) | |
| Enumeration Date | 2006-12-05 |
| Last Update Date | 2018-10-19 |