| NPI | 1285629667 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: MO 2019028523) |
| Additional Taxonomies | 208VP0000X (Licence: IA MD-28604) |
| 208VP0000X (Licence: TN MD-56883) | |
| Enumeration Date | 2005-09-13 |
| Last Update Date | 2025-03-17 |