| NPI | 1194089011 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology Pain Medicine (Licence: MI 5101019964) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MI 5101019964) |
| Enumeration Date | 2012-06-25 |
| Last Update Date | 2022-05-24 |