| NPI | 1871563692 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: AZ 21996) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: AZ 21996) |
| Enumeration Date | 2006-01-24 |
| Last Update Date | 2010-10-27 |