| NPI | 1043294317 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: PA OS0097161) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: PA OS009716L) |
| Enumeration Date | 2005-12-01 |
| Last Update Date | 2025-06-03 |