| NPI | 1083061154 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NM MD2023-1566) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: NM MD2023-1566) |
| Enumeration Date | 2016-05-18 |
| Last Update Date | 2025-11-19 |