| NPI | 1083871164 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TN 53012) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MO 2023041821) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: TN 53012) | |
| Enumeration Date | 2008-05-17 |
| Last Update Date | 2024-02-22 |