| NPI | 1598729063 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: SC 27774) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: NC 97-01097) |
| Enumeration Date | 2006-04-13 |
| Last Update Date | 2025-03-27 |