| NPI | 1700852076 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: SD 5746) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: SD 37989) |
| Enumeration Date | 2006-02-27 |
| Last Update Date | 2024-02-07 |