| NPI | 1265424873 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: SD 8016) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: IA 32309) |
| Enumeration Date | 2005-08-19 |
| Last Update Date | 2022-09-01 |