| NPI | 1366670457 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology Pain Medicine (Licence: NC 2013-01758) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NC 2013-01758) |
| Enumeration Date | 2009-06-26 |
| Last Update Date | 2025-06-04 |