| NPI | 1508827593 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: MA 216741) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: RI MD11089) |
| Enumeration Date | 2006-03-29 |
| Last Update Date | 2015-09-23 |