| NPI | 1942866348 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX V2811) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: VA 0102206428) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: VA 0102206428) | |
| Enumeration Date | 2019-05-13 |
| Last Update Date | 2024-08-22 |