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 |