| NPI | 1942278403 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NH 13500) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MA 215980) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: NH 13500) | |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: MA 215980) | |
| Enumeration Date | 2006-03-10 |
| Last Update Date | 2024-10-01 |