| NPI | 1639675846 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: PR 22240) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: PR 22240) |
| Enumeration Date | 2018-04-05 |
| Last Update Date | 2024-08-06 |