| NPI | 1790893402 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology Pain Medicine (Licence: GA 048294) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TN 64974) |
| Enumeration Date | 2006-08-25 |
| Last Update Date | 2023-02-21 |