| NPI | 1659349439 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MD D66153) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: VA 0101238687) |
| 207L00000X Anesthesiology (Licence: PA MD483818) | |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: PA MD483818) | |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: VA 0101238687) | |
| Enumeration Date | 2006-03-09 |
| Last Update Date | 2024-02-08 |