| NPI | 1326627084 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: VA 0101289733) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: VA 0101289733) |
| Enumeration Date | 2021-04-07 |
| Last Update Date | 2026-10-08 |