| NPI | 1467849943 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: SC 87630) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: TN 61372) |
| Enumeration Date | 2015-04-22 |
| Last Update Date | 2022-09-16 |