NPI | 1780118737 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: MI 4301510315) |
Additional Taxonomies | 207L00000X Anesthesiology (Licence: MI 4301510315) |
Enumeration Date | 2017-04-17 |
Last Update Date | 2025-04-18 |