| NPI | 1669469326 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL MFC1619) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: IA SP130) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: IA SP130) | |
| Enumeration Date | 2005-09-28 |
| Last Update Date | 2008-06-20 |