| NPI | 1104280957 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: DC MD049275) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: MD D0089884) |
| Enumeration Date | 2016-04-07 |
| Last Update Date | 2021-08-11 |