| NPI | 1023458999 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: KY 51065) |
| Additional Taxonomies | 174400000X Specialist (Licence: KY 51065) |
| 207L00000X Anesthesiology (Licence: KY 51065) | |
| Enumeration Date | 2013-06-25 |
| Last Update Date | 2021-04-12 |