| NPI | 1568775443 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: MI 4301096579) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MI 4301096579) |
| Enumeration Date | 2010-07-20 |
| Last Update Date | 2016-01-20 |