| NPI | 1407176688 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: NV 20182) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: HI MD 18202) |
| Enumeration Date | 2010-06-10 |
| Last Update Date | 2021-07-22 |