| NPI | 1245692979 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: AZ 63122) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MA 282641) |
| Enumeration Date | 2016-03-22 |
| Last Update Date | 2024-08-08 |