NPI | 1124400593 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207LP2900X Anesthesiology Pain Medicine (Licence: MN 66498) |
Additional Taxonomies | 207L00000X Anesthesiology (Licence: MA 264050) |
Enumeration Date | 2015-06-22 |
Last Update Date | 2020-10-16 |