| NPI | 1609167741 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: OR MD183674) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MA 268417) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: MA 268417) | |
| Enumeration Date | 2011-04-24 |
| Last Update Date | 2018-10-15 |