| NPI | 1609225762 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology Pain Medicine (Licence: ID M-16138) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: UT 11709074-1205) |
| 207LP2900X Anesthesiology Pain Medicine (Licence: UT 11709074-1205) | |
| Enumeration Date | 2016-06-09 |
| Last Update Date | 2024-01-29 |