| NPI | 1851652150 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: SC 52510) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: KY 50629) |
| Enumeration Date | 2012-06-04 |
| Last Update Date | 2024-04-30 |