| NPI | 1669976692 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: AZ 73669) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: UT 12806045-1205) |
| Enumeration Date | 2018-03-23 |
| Last Update Date | 2024-09-10 |