| NPI | 1427555135 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: VA 0102207644) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: VA 0102207644) |
| Enumeration Date | 2018-04-09 |
| Last Update Date | 2023-01-30 |