| NPI | 1780681551 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: IA 1759) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: IA 1759) |
| Enumeration Date | 2005-07-07 |
| Last Update Date | 2014-01-09 |