| NPI | 1164951778 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: NV DO3160) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: IA R-10932) |
| Enumeration Date | 2017-06-07 |
| Last Update Date | 2024-02-12 |