| NPI | 1538395579 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: MI 4301094077) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MI 4301094077) |
| Enumeration Date | 2009-06-04 |
| Last Update Date | 2019-04-18 |