| NPI | 1841652872 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: KY 53919) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: KY R4140) |
| Enumeration Date | 2016-03-29 |
| Last Update Date | 2022-06-09 |