| NPI | 1902959034 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: CA A97757) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 241819) |
| Enumeration Date | 2007-01-20 |
| Last Update Date | 2015-05-12 |