| NPI | 1891954293 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: WA MD61140051) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: NV 13547) |
| 207L00000X Anesthesiology (Licence: NV 13547) | |
| Enumeration Date | 2008-06-02 |
| Last Update Date | 2025-10-13 |