| NPI | 1538543400 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: TN 60719) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TN 60719) |
| 207L00000X Anesthesiology (Licence: MS 959-L) | |
| Enumeration Date | 2015-07-10 |
| Last Update Date | 2020-06-04 |