| NPI | 1912494717 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology Pain Medicine (Licence: CA 20A19647) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX BP10063871) |
| 207L00000X Anesthesiology (Licence: CA 201A19647) | |
| Enumeration Date | 2018-04-17 |
| Last Update Date | 2023-08-16 |