| NPI | 1841678307 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: AZ 59113) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: AZ R74993) |
| 207R00000X Internal Medicine (Licence: AZ R74993) | |
| Enumeration Date | 2015-05-15 |
| Last Update Date | 2023-01-24 |