| NPI | 1518975507 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: MI RK038502) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MI RK038502) |
| Enumeration Date | 2006-08-04 |
| Last Update Date | 2011-04-28 |