| NPI | 1962993261 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: NE 34887) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NE 8200) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: IA MD-52095) | |
| Enumeration Date | 2018-05-22 |
| Last Update Date | 2024-04-01 |