NPI | 1720616204 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207L00000X Anesthesiology (Licence: WA OP61682891) |
Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: WA OP61682891) |
Enumeration Date | 2020-03-30 |
Last Update Date | 2025-08-19 |