| NPI | 1114345949 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: MS 28159) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: TN 59501) |
| Enumeration Date | 2014-03-29 |
| Last Update Date | 2023-10-18 |