| NPI | 1760260418 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: IA MD-55686) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: IA MD-55686) |
| Enumeration Date | 2023-09-14 |
| Last Update Date | 2025-10-07 |