NPI | 1407148091 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207LP2900X Anesthesiology Pain Medicine (Licence: NC 208623) |
Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX BP10041532) |
Enumeration Date | 2011-05-13 |
Last Update Date | 2021-03-09 |