| NPI | 1629085782 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: TX N0271) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL ME82325) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: FL ME82325) | |
| Enumeration Date | 2006-08-02 |
| Last Update Date | 2015-09-17 |