| NPI | 1013259175 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: NH 18888) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MA 270280) |
| Enumeration Date | 2013-03-26 |
| Last Update Date | 2022-07-21 |