| NPI | 1861648362 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: OR MD163027) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WA ML60019669) |
| Enumeration Date | 2008-08-15 |
| Last Update Date | 2013-08-14 |