| NPI | 1558548735 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: AZ 37959) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MA L-225536) |
| 174400000X Specialist (Licence: 37959) | |
| Enumeration Date | 2008-01-30 |
| Last Update Date | 2024-09-13 |