| NPI | 1972948552 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: LA 308513) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: AL 33571) |
| Enumeration Date | 2013-05-08 |
| Last Update Date | 2018-05-22 |