NPI | 1508216680 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: MS 27726) |
Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: UT 11550462-1205) |
208600000X Surgery (Licence: PA MT211207) | |
Enumeration Date | 2016-06-20 |
Last Update Date | 2021-08-30 |