NPI | 1437539723 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: FL ME145552) |
Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: AL MD.41249) |
207L00000X Anesthesiology (Licence: TX S2592) | |
207L00000X Anesthesiology (Licence: PA MT208191) | |
Enumeration Date | 2015-06-02 |
Last Update Date | 2020-08-12 |