| NPI | 1922043371 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TN 61386) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OR MD125903) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: TN 61386) | |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: OR MD125903) | |
| Enumeration Date | 2006-06-19 |
| Last Update Date | 2022-03-31 |