| NPI | 1740416643 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MA 256719) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: MA 256719) |
| Enumeration Date | 2009-06-05 |
| Last Update Date | 2014-04-11 |