| NPI | 1730340902 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: NY 279837) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: WA MD00049215) |
| Enumeration Date | 2008-06-20 |
| Last Update Date | 2015-11-19 |