| NPI | 1780971994 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: GA 84015) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: MO 2017043613) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: AL DO 1611) | |
| Enumeration Date | 2011-07-08 |
| Last Update Date | 2022-05-25 |