| NPI | 1598177891 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: ND 15745) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: ND PT15745) |
| Enumeration Date | 2014-05-21 |
| Last Update Date | 2021-09-22 |