NPI | 1972062875 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: KY 59587) |
Additional Taxonomies | 207L00000X Anesthesiology (Licence: NC 2023-00501) |
207L00000X Anesthesiology (Licence: KY 59587) | |
Enumeration Date | 2019-03-19 |
Last Update Date | 2024-11-13 |