NPI | 1093165789 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: LA 326211) |
Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: CA A166567) |
Enumeration Date | 2016-06-14 |
Last Update Date | 2023-12-22 |