| NPI | 1164943155 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology Pain Medicine (Licence: SC 87430) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NE 8088) |
| Enumeration Date | 2017-06-29 |
| Last Update Date | 2024-07-25 |