| NPI | 1649684838 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: PA MD466397) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA MT206208) |
| Enumeration Date | 2014-06-16 |
| Last Update Date | 2023-01-27 |