| NPI | 1902821739 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: KY 38717) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: KY 38717) |
| Enumeration Date | 2006-07-13 |
| Last Update Date | 2021-01-22 |