| NPI | 1326568734 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: NE 32171) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NE 32171) |
| 207L00000X Anesthesiology (Licence: MA 272708) | |
| 207R00000X Internal Medicine (Licence: MA 272708) | |
| Enumeration Date | 2017-06-27 |
| Last Update Date | 2023-08-03 |