| NPI | 1194727701 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: KY 29049) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: KY 29049) |
| 2083A0300X Preventive Medicine, Addiction Medicine (Licence: KY 29049) | |
| Enumeration Date | 2005-08-12 |
| Last Update Date | 2023-04-07 |