NPI | 1730562364 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207LP2900X Anesthesiology Pain Medicine (Licence: MN 72272) |
Additional Taxonomies | 207L00000X Anesthesiology (Licence: MA 272226) |
207LP2900X Anesthesiology Pain Medicine (Licence: TN 61043) | |
Enumeration Date | 2015-07-01 |
Last Update Date | 2024-01-31 |