| NPI | 1932312766 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: OR MD29175) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: WA MD60142376) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: WA MD60142376) | |
| Enumeration Date | 2007-05-08 |
| Last Update Date | 2016-05-25 |