| NPI | 1669455648 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: WI 26928) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: WI 26928-020) |
| Enumeration Date | 2005-11-23 |
| Last Update Date | 2018-11-14 |