| NPI | 1497141824 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: LA 311176) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TN 54922) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: TN 54922) | |
| Enumeration Date | 2015-04-13 |
| Last Update Date | 2020-06-12 |