| NPI | 1669813994 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: AZ 55185) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: MA 271672) |
| Enumeration Date | 2013-07-15 |
| Last Update Date | 2024-04-08 |