| NPI | 1720215601 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MO 2009014208) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: MO 2011016776) |
| Enumeration Date | 2009-06-17 |
| Last Update Date | 2015-10-14 |