| NPI | 1265753164 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: NE 26376) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NE 26376) |
| 2083A0100X Preventive Medicine, Aerospace Medicine (Licence: NE 26376) | |
| Enumeration Date | 2010-06-15 |
| Last Update Date | 2025-12-05 |