| NPI | 1770568420 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: DC 32095) |
| Additional Taxonomies | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: DC MD32095) |
| Enumeration Date | 2005-12-14 |
| Last Update Date | 2019-05-29 |