| NPI | 1336305002 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: MD D80998) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: VA 0101250847) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: VA 0101250847) | |
| Enumeration Date | 2008-08-01 |
| Last Update Date | 2021-07-26 |