| NPI | 1205360492 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: ME md26139) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: UT 12233818-1205) |
| Enumeration Date | 2017-04-14 |
| Last Update Date | 2023-08-23 |