| NPI | 1336671916 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: MI 5101026675) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MI 5101026675) |
| 208VP0000X (Licence: MI 5101026675) | |
| Enumeration Date | 2017-04-01 |
| Last Update Date | 2025-04-14 |