NPI | 1710373089 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: WA MD61040049) |
Additional Taxonomies | 207L00000X Anesthesiology (Licence: WA MD61040049) |
Enumeration Date | 2015-04-13 |
Last Update Date | 2021-12-01 |