| NPI | 1568872182 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: VA 0101266084) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: IA R-09919) |
| Enumeration Date | 2014-05-05 |
| Last Update Date | 2020-12-10 |