| NPI | 1093209157 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: VA 0101276457) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: VA 0101276457) |
| 207R00000X Internal Medicine (Licence: PA MT216753) | |
| Enumeration Date | 2018-06-21 |
| Last Update Date | 2023-01-06 |