| NPI | 1881012441 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: NC 2019-01531) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NC 2019-01531) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: SC 82514) | |
| Enumeration Date | 2014-04-01 |
| Last Update Date | 2021-10-07 |