| NPI | 1366822926 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: ID M15294) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OR BP10053072) |
| 207L00000X Anesthesiology (Licence: ID M15294) | |
| Enumeration Date | 2015-06-08 |
| Last Update Date | 2022-10-28 |