| NPI | 1912948944 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0000X (Licence: GA 035354) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: GA 035354) |
| Enumeration Date | 2006-06-09 |
| Last Update Date | 2025-09-11 |