| NPI | 1649281460 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL OS7787) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: FL OS7787) |
| Enumeration Date | 2006-08-10 |
| Last Update Date | 2007-07-08 |