| NPI | 1194761221 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: VA 0101280870) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA MD059260L) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: VA 0101280870) | |
| Enumeration Date | 2006-06-20 |
| Last Update Date | 2024-04-01 |