| NPI | 1679992051 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: TN 53674) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TN 53674) |
| 208VP0000X Pain Medicine, Pain Medicine (Licence: TN 53674) | |
| Enumeration Date | 2014-04-14 |
| Last Update Date | 2023-08-29 |