NPI | 1104386853 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: FL ME166357) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC H0071) |
Enumeration Date | 2019-03-20 |
Last Update Date | 2024-03-27 |