| NPI | 1518178763 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: NM MD2010-023) |
| Additional Taxonomies | 208VP0000X (Licence: NM MD2010-0239) |
| Enumeration Date | 2007-05-26 |
| Last Update Date | 2024-11-07 |