| NPI | 1164413696 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: HI MD-19618) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MA 224282) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: AZ 35264) | |
| Enumeration Date | 2005-11-03 |
| Last Update Date | 2020-06-03 |