| NPI | 1801059118 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: MA 251704) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: MA 251704) |
| Enumeration Date | 2008-07-07 |
| Last Update Date | 2013-11-08 |