| NPI | 1760945992 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: VA 0101282612) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: WI 81828) |
| Enumeration Date | 2019-04-14 |
| Last Update Date | 2024-10-17 |