| NPI | 1528156155 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0000X (Licence: MD D0041218) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: MD D0041218) |
| Enumeration Date | 2006-10-10 |
| Last Update Date | 2009-09-25 |