| NPI | 1548675663 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: CA A152947) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: AZ 58125) |
| Enumeration Date | 2014-06-26 |
| Last Update Date | 2020-12-10 |