| NPI | 1124656608 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: OR MD219144) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OR MD219144) |
| Enumeration Date | 2020-03-30 |
| Last Update Date | 2025-07-02 |