| NPI | 1487064663 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: NC 2019-00099) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NC 2019-00099) |
| Enumeration Date | 2014-04-28 |
| Last Update Date | 2021-08-13 |