| NPI | 1609916311 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: MD D73475) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: VT 042.0013903) |
| 207L00000X Anesthesiology (Licence: MD D73475) | |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: OH 35.121452) | |
| Enumeration Date | 2007-02-08 |
| Last Update Date | 2023-10-26 |