| NPI | 1629290689 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: TN MD44681) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: AL 26794) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: AL MD26794) | |
| Enumeration Date | 2007-05-02 |
| Last Update Date | 2017-03-28 |