| NPI | 1194017863 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: GA 076687) |
| Additional Taxonomies | 207LP2900X Anesthesiology Pain Medicine (Licence: GA 076687) |
| Enumeration Date | 2011-05-12 |
| Last Update Date | 2021-12-15 |