| NPI | 1407804495 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology Pain Medicine (Licence: MO 2003009569) |
| Additional Taxonomies | 207LP2900X Anesthesiology Pain Medicine (Licence: KS 04-28294) |
| Enumeration Date | 2006-05-04 |
| Last Update Date | 2022-07-21 |