| NPI | 1568494615 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: NH 11602) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: MA 204656) |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2007-07-08 |