| NPI | 1609103464 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: UT 9308930-1204) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: AZ R1727) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: NH RT2475) | |
| Enumeration Date | 2009-11-15 |
| Last Update Date | 2017-04-04 |