| NPI | 1912039850 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: OK 32172) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OK 32172) |
| Enumeration Date | 2007-03-09 |
| Last Update Date | 2025-09-17 |