| NPI | 1851336440 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: MA 227383) | 
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MA 227383) | 
| Enumeration Date | 2006-06-18 | 
| Last Update Date | 2010-09-30 |