| NPI | 1225265200 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: VA 0101248044) |
| Additional Taxonomies | 208D00000X General Practice (Licence: VA 0101248044) |
| Enumeration Date | 2009-06-17 |
| Last Update Date | 2021-12-21 |