| NPI | 1417940321 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: MO 2014015594) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: IA 35473) |
| 207L00000X Anesthesiology (Licence: MO 2014015594) | |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: IA 35473) | |
| Enumeration Date | 2005-08-25 |
| Last Update Date | 2023-08-16 |