| NPI | 1750333233 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: WA MD6458807) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: MS 20625) |
| Enumeration Date | 2006-05-16 |
| Last Update Date | 2015-01-20 |