| NPI | 1902247968 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: MA 286138) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MD D90291) |
| 207L00000X Anesthesiology (Licence: MA 286138) | |
| Enumeration Date | 2013-07-07 |
| Last Update Date | 2023-03-06 |