| NPI | 1316478258 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: VA 0101272076) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: WA ML60754900) |
| Enumeration Date | 2017-03-22 |
| Last Update Date | 2021-07-29 |