| NPI | 1154465326 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: MO 2026013335) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OK 39937) |
| Enumeration Date | 2007-02-19 |
| Last Update Date | 2026-04-15 |