| NPI | 1700176971 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: CA A135483) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CA A135483) |
| 207L00000X Anesthesiology (Licence: PA MD454707) | |
| 207L00000X Anesthesiology (Licence: NY 283943) | |
| Enumeration Date | 2011-04-08 |
| Last Update Date | 2023-01-03 |