| NPI | 1558425710 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: MO 2000174760) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MO 2000174760) |
| Enumeration Date | 2006-12-21 |
| Last Update Date | 2015-11-25 |