| NPI | 1457411704 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: AZ 40347) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: MA 231477) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: AZ 40347) | |
| Enumeration Date | 2006-12-09 |
| Last Update Date | 2022-05-27 |