| NPI | 1689739021 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: NE 23283) |
| Additional Taxonomies | 207LP2900X Anesthesiology Pain Medicine (Licence: IA 25824) |
| Enumeration Date | 2006-12-26 |
| Last Update Date | 2021-03-25 |