| NPI | 1558701151 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: MO 2017020533) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MO 2017020533) |
| Enumeration Date | 2013-06-27 |
| Last Update Date | 2025-04-17 |