| NPI | 1205898137 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology Pain Medicine (Licence: TN 61375) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CO 37926) |
| Enumeration Date | 2006-04-05 |
| Last Update Date | 2024-11-11 |