| NPI | 1033606926 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: GA 95746) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: GA 95746) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: AL 44110) | |
| 207L00000X Anesthesiology (Licence: TX Bp10063369) | |
| Enumeration Date | 2018-04-17 |
| Last Update Date | 2026-04-02 |