| NPI | 1992806525 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: NY 260670) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: WI 47034) |
| 208VP0000X Pain Medicine, Pain Medicine (Licence: WI 47034) | |
| 207L00000X Anesthesiology (Licence: NY 260670) | |
| Enumeration Date | 2006-09-26 |
| Last Update Date | 2012-03-07 |