| NPI | 1821442849 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: KY TP323) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: NJ 25MA10731600) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: OH 35.143113) | |
| Enumeration Date | 2016-04-15 |
| Last Update Date | 2022-03-08 |