| NPI | 1003379215 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: MA 1018162) | 
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MA 1018162) | 
| Enumeration Date | 2019-04-14 | 
| Last Update Date | 2024-08-20 |