| NPI | 1154303493 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: MD D35409) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MD D0035409) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: AZ 47720) | |
| Enumeration Date | 2005-11-14 |
| Last Update Date | 2023-03-20 |