| NPI | 1528149820 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: LA MD 202818) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: AL 28845) |
| Enumeration Date | 2006-10-17 |
| Last Update Date | 2010-01-19 |