| NPI | 1376986604 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: OK 30777) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OK 30777) |
| Enumeration Date | 2013-04-17 |
| Last Update Date | 2023-05-03 |