| NPI | 1730538745 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: TX V4121) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: IA R-10601) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: IL 036.157367) | |
| Enumeration Date | 2016-06-09 |
| Last Update Date | 2025-09-11 |