| NPI | 1942658059 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: TX s6000) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: HI MD-22005) |
| Enumeration Date | 2016-05-31 |
| Last Update Date | 2024-01-17 |