| NPI | 1982695060 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: PA 05008203L) |
| Additional Taxonomies | 208VP0000X Pain Medicine, Pain Medicine (Licence: PA 05008203L) |
| Enumeration Date | 2005-10-28 |
| Last Update Date | 2014-01-22 |