| NPI | 1003233123 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: MO 2021021858)  | 
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: WI 6465420)  | 
| 207L00000X Anesthesiology (Licence: MO 2021021858)  | |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: WI 6465420)  | |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: IN 01082023A)  | |
| Enumeration Date | 2014-03-26 | 
| Last Update Date | 2022-02-24 |