| NPI | 1518017441 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MD D0067379) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: VA 0101240994) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: VA 0101240994) | |
| Enumeration Date | 2007-01-11 |
| Last Update Date | 2013-04-18 |