| NPI | 1770500431 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology Pain Medicine (Licence: WI 40486-020) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: WI 40486020) |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2014-02-03 |