| NPI | 1750743480 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: CA A167141) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CA A167141) |
| 207L00000X Anesthesiology (Licence: CT 68102) | |
| 207L00000X Anesthesiology (Licence: NY 301993) | |
| Enumeration Date | 2016-03-22 |
| Last Update Date | 2024-05-29 |