| NPI | 1124348784 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: PA MD472837) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: WA MD60562878) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: WA MD60562878) | |
| Enumeration Date | 2010-06-07 |
| Last Update Date | 2021-09-10 |