| NPI | 1821073107 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: CT 018808) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CT 018808) |
| Enumeration Date | 2005-12-09 |
| Last Update Date | 2008-06-25 |