| NPI | 1881695047 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TN 29555) |
| Additional Taxonomies | 207LP2900X Anesthesiology Pain Medicine (Licence: TN 29555) |
| Enumeration Date | 2005-08-09 |
| Last Update Date | 2017-08-03 |