| NPI | 1588604698 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: CT 042675) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: MA 210744) |
| Enumeration Date | 2006-06-07 |
| Last Update Date | 2019-09-25 |