| NPI | 1033606926 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: AL 44110)  | 
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX Bp10063369)  | 
| Enumeration Date | 2018-04-17 | 
| Last Update Date | 2023-01-12 |