| NPI | 1679615686 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: KY 43136) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: IN 01068095A) |
| Enumeration Date | 2007-02-13 |
| Last Update Date | 2024-02-13 |