| NPI | 1760625628 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: AR E-8839) | 
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: AR E-8839) | 
| Enumeration Date | 2009-04-08 | 
| Last Update Date | 2023-07-27 |