| NPI | 1467795211 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: MD D0088865) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MI 4301103927) |
| 207L00000X Anesthesiology (Licence: VA 0101264354) | |
| Enumeration Date | 2013-03-30 |
| Last Update Date | 2021-01-14 |