| NPI | 1598394181 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology Pain Medicine (Licence: CO DR.0075826) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: UT 12420135-1205) |
| Enumeration Date | 2020-04-06 |
| Last Update Date | 2025-07-14 |