| NPI | 1386030740 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology Pain Medicine (Licence: IN 01083840A) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OH 57.026947) |
| Enumeration Date | 2015-04-13 |
| Last Update Date | 2020-12-18 |