| NPI | 1942335245 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: TX J5646) |
| Additional Taxonomies | 207LP2900X Anesthesiology Pain Medicine (Licence: TX J5646) |
| 207L00000X Anesthesiology (Licence: TX J5646) | |
| Enumeration Date | 2007-02-23 |
| Last Update Date | 2016-07-11 |