| NPI | 1568442762 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NC 9601371) |
| Additional Taxonomies | 207LP2900X Anesthesiology Pain Medicine (Licence: NC 9601371) |
| Enumeration Date | 2006-01-23 |
| Last Update Date | 2011-07-01 |