| NPI | 1417394131 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: NH 18789) | 
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NH 18789) | 
| Enumeration Date | 2013-06-04 | 
| Last Update Date | 2025-06-23 |