| NPI | 1578094231 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: MO 2019022752) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MO 2019022752) |
| Enumeration Date | 2017-03-24 |
| Last Update Date | 2024-04-25 |