| NPI | 1609854520 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: KY 02267) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: IN 02001309A) |
| Enumeration Date | 2006-01-03 |
| Last Update Date | 2022-05-13 |