| NPI | 1487115424 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: WI 75286) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: WI 75286) |
| Enumeration Date | 2019-03-30 |
| Last Update Date | 2023-06-06 |