| NPI | 1952352767 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: LA 09899R) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: LA MD.09899R) |
| Enumeration Date | 2006-05-15 |
| Last Update Date | 2023-04-24 |