| NPI | 1225410541 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology Pain Medicine (Licence: OR MD201330) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OR MD201330) |
| Enumeration Date | 2015-06-23 |
| Last Update Date | 2020-09-11 |