NPI | 1609167741 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207L00000X Anesthesiology (Licence: OR MD183674) |
Additional Taxonomies | 207L00000X Anesthesiology (Licence: MA 268417) |
207LP2900X Anesthesiology, Pain Medicine (Licence: MA 268417) | |
Enumeration Date | 2011-04-24 |
Last Update Date | 2018-10-15 |