| NPI | 1093190415 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: NV 20191) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: KY R3810) |
| Enumeration Date | 2015-07-27 |
| Last Update Date | 2020-10-06 |