| NPI | 1205361276 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: MT MED-PHYS-LIC-110455) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MA 281410) |
| 207L00000X Anesthesiology (Licence: MT MED-PHYS-LIC-110455) | |
| Enumeration Date | 2017-04-26 |
| Last Update Date | 2026-03-27 |