| NPI | 1629695135 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: MD D0104047) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MD D0104047) |
| Enumeration Date | 2020-06-30 |
| Last Update Date | 2025-07-01 |