| NPI | 1629067319 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MA 154452) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: MA 154452) |
| Enumeration Date | 2005-10-17 |
| Last Update Date | 2020-11-25 |