| NPI | 1023436128 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: TX T5201) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MI 4301105246) |
| Enumeration Date | 2014-04-04 |
| Last Update Date | 2023-09-20 |