| NPI | 1164837415 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: GA 81636) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: GA 6826) |
| Enumeration Date | 2014-06-25 |
| Last Update Date | 2023-10-26 |