| NPI | 1700812898 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology Pain Medicine (Licence: OR 13551) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OR MD13551) |
| Enumeration Date | 2006-06-23 |
| Last Update Date | 2012-12-12 |