| NPI | 1609684133 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: IA SP-0293) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: IA SP-0293) |
| Enumeration Date | 2024-12-30 |
| Last Update Date | 2025-03-31 |