| NPI | 1982882239 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: CT 047620) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CT 047620) |
| 208VP0000X (Licence: CT 047620) | |
| Enumeration Date | 2008-02-07 |
| Last Update Date | 2025-08-04 |