| NPI | 1891717781 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: MO 2007016510) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TN 39472) |
| 207L00000X Anesthesiology (Licence: MO 2007016510) | |
| Enumeration Date | 2006-07-23 |
| Last Update Date | 2016-10-20 |