| NPI | 1720060734 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CT 035482) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: CT 035482) |
| Enumeration Date | 2005-11-16 |
| Last Update Date | 2011-03-31 |