| NPI | 1972946978 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: MA 273494) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MA 258768) |
| Enumeration Date | 2013-04-10 |
| Last Update Date | 2024-09-30 |